Healthcare Provider Details

I. General information

NPI: 1376680041
Provider Name (Legal Business Name): SANIBEL MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 08/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2499 PALM RIDGE RD
SANIBEL FL
33957-3201
US

IV. Provider business mailing address

PO BOX 628
SANIBEL FL
33957-0628
US

V. Phone/Fax

Practice location:
  • Phone: 239-395-2005
  • Fax: 239-395-0042
Mailing address:
  • Phone: 239-395-2005
  • Fax: 239-395-0042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY N WRIGHT
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 239-395-2005