MEDICARE: ASSOCIATES IN NEUROLOGICAL CARE OF LEE COUNTY

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
1	174400000X	Specialist	ME0054295	FL

General Provider Information

NPI Number	:	1528257086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATES IN NEUROLOGICAL CARE OF LEE COUNTY

Provider Business Mailing Address
First Line	:	38 BARKLEY CIR
Second Line	:	SUITE 2
City	:	FORT MYERS
State	:	FL
Zip	:	33907-7526
Country	:	US
Telephone Number	:	239-939-4611
Fax Number	:	239-939-9062

Provider Business Practice Location Address
First Line	:	38 BARKLEY CIR
Second Line	:	SUITE 2
City	:	FORT MYERS
State	:	FL
Zip	:	33907-7526
Country	:	US
Telephone Number	:	239-939-4611
Fax Number	:	239-939-9062

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GERARDO A GAMEZ
Credential	:	MP
Telephone Number	:	239-939-4611

Provider Enumeration Date	:	10/22/2007
Last Update Date	:	10/25/2007

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