Healthcare Provider Details

I. General information

NPI: 1295730216
Provider Name (Legal Business Name): AMPUTEE CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 BARKLEY CIR
FORT MYERS FL
33907-7530
US

IV. Provider business mailing address

44 BARKLEY CIR
FORT MYERS FL
33907-7530
US

V. Phone/Fax

Practice location:
  • Phone: 239-437-4010
  • Fax: 239-437-4097
Mailing address:
  • Phone: 239-437-4010
  • Fax: 239-437-4097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. AVRAHAM R BENHAIM
Title or Position: OWNER
Credential:
Phone: 239-437-4010