Healthcare Provider Details

I. General information

NPI: 1518923127
Provider Name (Legal Business Name): CRAIG PATRICK GINDELE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8190 LITTLETON RD SUITE 103
N FT MYERS FL
33903
US

IV. Provider business mailing address

8190 LITTLETON RD SUITE 103
N FT MYERS FL
33903
US

V. Phone/Fax

Practice location:
  • Phone: 239-997-8200
  • Fax: 239-997-8332
Mailing address:
  • Phone: 239-997-8200
  • Fax: 239-997-8332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH0003494
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: