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General NPI Number Information
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NPI Number | 1013689892
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Entity Type | Organization
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Legal Business Name | ENT CAPE CORAL LLC
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 4202 DEL PRADO BLVD S
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City | CAPE CORAL
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State | FL
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Zip | 33904-7166
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Country | US
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Telephone | 239-350-0129
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 SW 52ND TER
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City | CAPE CORAL
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State | FL
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Zip | 33914-7485
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Country | US
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Telephone | 239-738-9882
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. LISA ZARRANZ
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Credential |
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Telephone | 239-738-9882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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