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General NPI Number Information
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NPI Number | 1235595547
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Entity Type | Organization
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Legal Business Name | IONA MEDICAL CENTER LLC
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Dates
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Enumeration Date | 01/04/2016
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 15550 MCGREGOR BLVD SUITE 101
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City | FORT MYERS
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State | FL
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Zip | 33908-2579
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Country | US
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Telephone | 239-689-6820
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Fax |
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Provider Business Mailing Address
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Address Line | 15550 MCGREGOR BLVD SUITE 101
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City | FORT MYERS
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State | FL
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Zip | 33908-2579
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Country | US
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Telephone | 239-689-6820
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. GREGG R SONN
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Credential | DO
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Telephone | 239-989-2586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | FL
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