Healthcare Provider Details

I. General information

NPI: 1386884385
Provider Name (Legal Business Name): ASSOCIATES IN MEDICINE & SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8851 BOARDROOM CIR
FORT MYERS FL
33919-4888
US

IV. Provider business mailing address

8851 BOARDROOM CIR
FORT MYERS FL
33919-4888
US

V. Phone/Fax

Practice location:
  • Phone: 239-481-7000
  • Fax: 239-433-8999
Mailing address:
  • Phone: 239-481-7000
  • Fax: 239-433-8999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateFL

VIII. Authorized Official

Name: H A CHARARA
Title or Position: CEO
Credential:
Phone: 239-689-8900