SOUTHWEST FLORIDA FERTILITY CENTER PA NPI 1588749618

NPI Information

SOUTHWEST FLORIDA FERTILITY CENTER PA is a reproductive endocrinology obstetrics gynecology in Fort Myers, FL. The provider is an obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. SOUTHWEST FLORIDA FERTILITY CENTER PA NPI is 1588749618. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

15730 NEW HAMPSHIRE CT
SUITE 101
FORT MYERS, FL
ZIP 33908
Phone: (239) 561-3430
Fax: (239) 561-6980

The provider's authorized official is Jacob Leon Glock .
The authorized official title is President and has the following contact phone number (239) 561-3430.

The CLIA number assigned to this NPI record is 10D0915278 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/26/2006 and was last updated on 1/12/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.