Healthcare Provider Details

I. General information

NPI: 1184196628
Provider Name (Legal Business Name): JOINT IMPLANT SURGEONS OF FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2018
Last Update Date: 12/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 CROSSPOINTE DR STE 108
NAPLES FL
34110-0918
US

IV. Provider business mailing address

7331 COLLEGE PKWY STE 300
FORT MYERS FL
33907-5524
US

V. Phone/Fax

Practice location:
  • Phone: 239-337-2003
  • Fax: 239-337-3168
Mailing address:
  • Phone: 239-337-2003
  • Fax: 239-337-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LEAH C MURPHY
Title or Position: BILLING MANAGER
Credential:
Phone: 239-337-2003