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General NPI Number Information
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NPI Number | 1023735909
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Entity Type | Organization
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Legal Business Name | BLUE SKY ORTHOPEDICS PLLC
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 4513 EXECUTIVE DR SUITE #102
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City | NAPLES
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State | FL
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Zip | 34119
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Country | US
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Telephone | 239-877-4662
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Fax | 866-439-5644
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Provider Business Mailing Address
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Address Line | 2338 IMMOKALEE RD STE 423
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City | NAPLES
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State | FL
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Zip | 34110-1445
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Country | US
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Telephone | 615-618-5555
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ROBERT D SWIFT
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Credential | DO
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Telephone | 615-618-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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