Healthcare Provider Details

I. General information

NPI: 1659158459
Provider Name (Legal Business Name): CIERA HOWARD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13010 METRO PKWY
FORT MYERS FL
33966-4701
US

IV. Provider business mailing address

25241 ELEMENTARY WAY STE 200
BONITA SPRINGS FL
34135-7883
US

V. Phone/Fax

Practice location:
  • Phone: 239-561-5616
  • Fax: 239-561-0345
Mailing address:
  • Phone: 239-947-4184
  • Fax: 399-474-1712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT40748
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: