MEDICARE: SOUTH FLORIDA EAR NOSE AND THROAT PLLC

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	207Y00000X	Otolaryngology Physician	ME 108882	FL

General Provider Information

NPI Number	:	1578648838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH FLORIDA EAR NOSE AND THROAT PLLC

Provider Business Mailing Address
First Line	:	1530 LEE BLVD
Second Line	:	STE 2350
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33936-4893
Country	:	US
Telephone Number	:	239-674-7345
Fax Number	:	239-491-2347

Provider Business Practice Location Address
First Line	:	1530 LEE BLVD
Second Line	:	STE 2350
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33936-4893
Country	:	US
Telephone Number	:	239-674-7345
Fax Number	:	239-491-2347

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MICHAEL A JAINDL
Credential	:	MD
Telephone Number	:	239-674-7345

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	11/09/2012

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