MEDICARE: ASCLEPIUSHEALTHGROUP,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1083114581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCLEPIUSHEALTHGROUP,LLC

Provider Business Mailing Address
First Line	:	1617 HENDRY ST STE 308
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-2934
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1617 HENDRY ST STE 308
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-2934
Country	:	US
Telephone Number	:	239-308-8217
Fax Number	:	239-236-1501

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. JEAN-JACQUE VEL
Credential	:	DO
Telephone Number	:	954-496-1170

Provider Enumeration Date	:	02/20/2018
Last Update Date	:	02/20/2018

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