Healthcare Provider Details

I. General information

NPI: 1023735909
Provider Name (Legal Business Name): BLUE SKY ORTHOPEDICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4513 EXECUTIVE DR SUITE #102
NAPLES FL
34119
US

IV. Provider business mailing address

2338 IMMOKALEE RD STE 423
NAPLES FL
34110-1445
US

V. Phone/Fax

Practice location:
  • Phone: 239-877-4662
  • Fax: 866-439-5644
Mailing address:
  • Phone: 615-618-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT D SWIFT
Title or Position: DIRECTOR
Credential: DO
Phone: 615-618-5555