Healthcare Provider Details

I. General information

NPI: 1790891653
Provider Name (Legal Business Name): CRAIG RICHARD SWEET M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 239-275-8118
  • Fax: 239-275-5914
Mailing address:
  • Phone: 239-275-8118
  • Fax: 239-275-5914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberME0060184
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: