Healthcare Provider Details

I. General information

NPI: 1477854370
Provider Name (Legal Business Name): MEDFIT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9510 CORKSCREW PALMS CIR STE 1
ESTERO FL
33928-3308
US

IV. Provider business mailing address

1130 GOLDEN GATE BLVD W
NAPLES FL
34120-2175
US

V. Phone/Fax

Practice location:
  • Phone: 239-221-8299
  • Fax:
Mailing address:
  • Phone: 239-330-0232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. NEEL AMIN
Title or Position: CLINIC DIRECTOR
Credential: MD
Phone: 954-628-3355