Healthcare Provider Details

I. General information

NPI: 1639759475
Provider Name (Legal Business Name): SANTE PLUS MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3822 BROADWAY STE A&B
FORT MYERS FL
33901-8148
US

IV. Provider business mailing address

3822 BROADWAY STE A&B
FORT MYERS FL
33901-8148
US

V. Phone/Fax

Practice location:
  • Phone: 239-603-2377
  • Fax: 561-293-7717
Mailing address:
  • Phone: 239-603-2377
  • Fax: 561-293-7717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MEGAN HAAPANEN
Title or Position: PRACTICE ADMIN
Credential:
Phone: 239-482-8788