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General NPI Number Information
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NPI Number | 1821420845
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Entity Type | Organization
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Legal Business Name | GENTLE CARE OB GYN AND INFERTILITY CORP
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 3615 CENTRAL AVE STE 7
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City | FORT MYERS
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State | FL
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Zip | 33901-8257
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Country | US
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Telephone | 239-939-3100
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Fax | 239-939-3104
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Provider Business Mailing Address
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Address Line | 3615 CENTRAL AVE STE 7
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City | FORT MYERS
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State | FL
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Zip | 33901-8257
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Country | US
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Telephone | 239-939-3100
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Fax | 239-939-3104
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. NORRIS MICHAEL ALLEN
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Credential | MD
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Telephone | 239-939-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME100568
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License Number State | FL
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