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General NPI Number Information
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NPI Number | 1285936575
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Entity Type | Organization
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Legal Business Name | BOTINA SPRINGS MEDICAL GROUP
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Dates
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Enumeration Date | 11/19/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 9240 BONITA BEACH RD SE STE 2200
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4251
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Country | US
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Telephone | 239-221-7497
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Fax | 239-405-8132
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Provider Business Mailing Address
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Address Line | 9240 BONITA BEACH RD SE STE 2200
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4251
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Country | US
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Telephone | 239-221-7497
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Fax | 239-405-8132
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SONIA NAVARRO
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Credential |
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Telephone | 239-221-7497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | HCC8931
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License Number State | FL
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