MEDICARE: ASSOCIATES IN MEDICINE & SURGERY 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	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1194185579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATES IN MEDICINE & SURGERY LLC

Provider Business Mailing Address
First Line	:	13240 N CLEVELAND AVE
Second Line	:	SUITE 3
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-4855
Country	:	US
Telephone Number	:	239-997-1000
Fax Number	:	239-997-5404

Provider Business Practice Location Address
First Line	:	13240 N CLEVELAND AVE
Second Line	:
City	:	N FORT MYERS
State	:	FL
Zip	:	33903-4855
Country	:	US
Telephone Number	:	239-977-1000
Fax Number	:	239-481-8150

Authorized Official
Title or Position	:	CEO
Name	:	H A CHARARA
Credential	:
Telephone Number	:	239-689-8900

Provider Enumeration Date	:	02/29/2016
Last Update Date	:	02/29/2016

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