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General NPI Number Information
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NPI Number | 1134501620
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Entity Type | Organization
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Legal Business Name | THE DOCTORS SURGICAL CENTER LLC
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 06/22/2015
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Provider Practice Location Address
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Address Line | 7431 GLADIOLUS DR
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City | FORT MYERS
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State | FL
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Zip | 33908-5122
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Country | US
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Telephone | 239-872-2467
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Fax |
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Provider Business Mailing Address
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Address Line | 7431 GLADIOLUS DR
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City | FORT MYERS
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State | FL
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Zip | 33908-5122
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Country | US
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Telephone | 239-872-2467
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | HUSNI CHARARA
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Credential | DPM
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Telephone | 239-872-2467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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