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General NPI Number Information
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NPI Number | 1114311370
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Entity Type | Organization
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Legal Business Name | CLINICAL RESEARCH WEST COAST.INC
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 3660 CENTRAL AVE STE 9
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City | FORT MYERS
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State | FL
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Zip | 33901-8258
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Country | US
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Telephone | 239-208-9677
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Fax | 239-208-9679
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Provider Business Mailing Address
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Address Line | 3660 CENTRAL AVE STE 9
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City | FORT MYERS
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State | FL
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Zip | 33901-8258
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Country | US
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Telephone | 239-208-9677
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Fax | 239-208-9679
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CHRIS RICARDO MARTINEZ
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Credential |
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Telephone | 954-665-0430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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