Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2006-02-14
- Last updated
- 2025-05-31
Licenses
- License FL
- 10D0696966
- License FL
- 10D0294870
Location
- Practice location
- 1620 MEDICAL LN, SUITE 100
- City
- FORT MYERS FL
- Postal code
- 339071143
- Phone
- 239-275-1164
Organization contact
- Name
- DARREN WHEELER
- Title
- Vice President
- Phone
- 7027337866
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
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