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General NPI Number Information
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NPI Number | 1811520901
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Entity Type | Organization
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Legal Business Name | FLORIDA GULF COAST UNIVERSITY
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 10501 FGCU BLVD S
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City | FORT MYERS
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State | FL
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Zip | 33965-6565
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Country | US
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Telephone | 239-590-7462
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Fax |
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Provider Business Mailing Address
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Address Line | 10501 FGCU BLVD S
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City | FORT MYERS
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State | FL
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Zip | 33965-6565
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Country | US
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Telephone | 239-590-7462
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER II
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Name | ANNE HANSEN
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Credential |
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Telephone | 239-590-7462
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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 |
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License Number State |
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