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General NPI Number Information
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NPI Number | 1891929477
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Entity Type | Organization
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Legal Business Name | LUXOR INDUSTRIES-PHYSICIANS GROUP NORTH FORT MYERS FL DIVISION LLC
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 1890 N TAMIAMI TRL UNIT F
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-3340
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Country | US
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Telephone | 863-244-9585
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Fax |
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Provider Business Mailing Address
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Address Line | 1890 N. TAMIAMI TRAIL UNIT F
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City | NORTH FORT MYERS
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State | FL
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Zip | 33917
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING PRESIDENT
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Name | CHERYL LYNN E SWEENEY
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Credential |
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Telephone | 727-674-8079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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