Healthcare Provider Details

I. General information

NPI: 1568710853
Provider Name (Legal Business Name): FMB MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2012
Last Update Date: 05/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7205 ESTERO BLVD STE 733
FORT MYERS BEACH FL
33931-4779
US

IV. Provider business mailing address

7205 ESTERO BLVD STE 733
FORT MYERS BEACH FL
33931-4779
US

V. Phone/Fax

Practice location:
  • Phone: 239-463-5741
  • Fax: 239-463-5578
Mailing address:
  • Phone: 239-463-5741
  • Fax: 239-463-5578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: NITA DRUMM
Title or Position: ADMINISTRATOR
Credential:
Phone: 239-463-5741