Healthcare Provider Details

I. General information

NPI: 1164165643
Provider Name (Legal Business Name): SNIGDHA ILA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 HEALTH CENTER BLVD STE 1700
ESTERO FL
34135-7347
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-468-0360
  • Fax: 239-468-7944
Mailing address:
  • Phone: 239-468-0360
  • Fax: 239-468-7944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS20526
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License NumberOS20526
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: