Healthcare Provider Details

I. General information

NPI: 1336800721
Provider Name (Legal Business Name): ALLIED FAMILY HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3208 CHIQUITA BLVD S STE 108
CAPE CORAL FL
33914-4267
US

IV. Provider business mailing address

3208 CHIQUITA BLVD S STE 108
CAPE CORAL FL
33914-4267
US

V. Phone/Fax

Practice location:
  • Phone: 800-933-2076
  • Fax:
Mailing address:
  • Phone: 800-933-2076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMY L GONZALEZ
Title or Position: PRESIDENT
Credential: APRN
Phone: 239-319-3933