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General NPI Number Information
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NPI Number | 1306109137
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Entity Type | Organization
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Legal Business Name | SFWC MEDICAL INC
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 06/18/2012
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Provider Practice Location Address
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Address Line | 16970 SAN CARLOS BLVD STE 120
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City | FORT MYERS
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State | FL
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Zip | 33908-1236
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Country | US
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Telephone | 239-454-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 16970 SAN CARLOS BLVD STE 120
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City | FORT MYERS
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State | FL
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Zip | 33908-1236
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Country | US
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Telephone | 239-454-6700
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Fax |
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Authorized Official
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Title or Position | FINANCIAL OFFICE
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Name | CYNTHIA RUE
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Credential |
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Telephone | 239-454-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | HCC9328
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License Number State | FL
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