Healthcare Provider Details

I. General information

NPI: 1699960435
Provider Name (Legal Business Name): SYPERT INSTITUTE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date: 05/19/2009
Reactivation Date: 09/28/2011

III. Provider practice location address

26800 TAMIAMI TRAIL SOUTH SUITE 340
BONITA SPRINGS FL
34134-4349
US

IV. Provider business mailing address

632 DEL PRADO BLVD N
CAPE CORAL FL
33909-2253
US

V. Phone/Fax

Practice location:
  • Phone: 239-498-1204
  • Fax: 239-498-1350
Mailing address:
  • Phone: 239-772-5577
  • Fax: 239-772-9961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT OGRADY
Title or Position: VICE PRESIDENT
Credential:
Phone: 239-432-0774