Healthcare Provider Details

I. General information

NPI: 1144887274
Provider Name (Legal Business Name): EMBRYO DONATION INTERNATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 05/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12611 WORLD PLAZA LN BLDG 53
FORT MYERS FL
33907-3990
US

IV. Provider business mailing address

12611 WORLD PLAZA LN BLDG 53
FORT MYERS FL
33907-3990
US

V. Phone/Fax

Practice location:
  • Phone: 239-275-5728
  • Fax:
Mailing address:
  • Phone: 239-275-5728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CRAIG SWEET
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 239-275-5728