Healthcare Provider Details

I. General information

NPI: 1033307285
Provider Name (Legal Business Name): HARRY COTLER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23421 WALDEN CENTER DR. STE. 100
BONITA SPRINGS FL
34134-4911
US

IV. Provider business mailing address

PO BOX 799
ESTERO FL
33929-0799
US

V. Phone/Fax

Practice location:
  • Phone: 239-444-0700
  • Fax: 239-444-0900
Mailing address:
  • Phone: 907-398-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO3942
License Number StateFL

VIII. Authorized Official

Name: HARRY COTLER
Title or Position: OWNER/PRESIDENT/PHYSICIAN
Credential: DPM
Phone: 239-444-0700