Healthcare Provider Details

I. General information

NPI: 1932503851
Provider Name (Legal Business Name): PHYSICIANS FOR QUALITY HEALTHCARE,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2014
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 DEL PRADO BLVD S STE 201
CAPE CORAL FL
33990-5703
US

IV. Provider business mailing address

6150 DIAMOND CENTRE CT BLDG 100
FORT MYERS FL
33912-4367
US

V. Phone/Fax

Practice location:
  • Phone: 239-768-6396
  • Fax: 239-204-3000
Mailing address:
  • Phone: 239-768-6396
  • Fax: 239-204-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberHCC9815
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE GHANEM
Title or Position: CEO
Credential:
Phone: 239-768-6396