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General NPI Number Information
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NPI Number | 1497516389
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Entity Type | Organization
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Legal Business Name | MEDQUAD CARE CENTER LLC
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 4125 CLEVELAND AVE STE 1870
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City | FORT MYERS
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State | FL
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Zip | 33901-9064
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Country | US
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Telephone | 330-361-0831
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Fax |
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Provider Business Mailing Address
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Address Line | 1714 SW 10TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33991-3318
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Country | US
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Telephone | 330-361-0831
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABDALLAH AYYAD
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Credential |
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Telephone | 330-361-0831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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