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NPI Code Detail

MEDICARE: SWFL INTEGRATIVE MEDICINE, P.A.

MEDICARE: SWFL INTEGRATIVE MEDICINE, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician
2208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1386265254
Entity Type Code : Organization
Provider Name (Legal Business Name) : SWFL INTEGRATIVE MEDICINE, P.A.
Provider Business Mailing Address
First Line : 1570 COLONIAL BLVD STE A
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-1031
Country : US
Telephone Number : 239-208-6676
Fax Number :
Provider Business Practice Location Address
First Line : 1570 COLONIAL BLVD STE A
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-1031
Country : US
Telephone Number : 239-208-6676
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. HEATHER V AULD
Credential : MD
Telephone Number : 239-208-6676
Provider Enumeration Date : 05/02/2020
Last Update Date : 05/02/2020

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Directions to “SWFL INTEGRATIVE MEDICINE, P.A. ” Practice Location

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