Healthcare Provider Details

I. General information

NPI: 1457711830
Provider Name (Legal Business Name): ASSOCIATES IN MEDICINE & SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2016
Last Update Date: 02/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8851 BOARDROOM CIR
FORT MYERS FL
33919-4888
US

IV. Provider business mailing address

217 DEL PRADO BLVD S SUITE 201
CAPE CORAL FL
33990-1743
US

V. Phone/Fax

Practice location:
  • Phone: 239-481-7000
  • Fax: 239-481-8150
Mailing address:
  • Phone: 239-573-1001
  • Fax: 239-573-1017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateFL

VIII. Authorized Official

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