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SOUTHWEST FLORIDA PROSTHETIC CLINIC NPI 1568596690


NPI Information

NPI: 1568596690
Provider Name: SOUTHWEST FLORIDA PROSTHETIC CLINIC

Former Legal Business Name: SOUTHWEST FLORIDA PROSTHETIC CLINIC

Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
13691 METRO PKWY
SUITE 100
FORT MYERS, FL
ZIP 33912
Phone: (239) 936-0033
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SOUTHWEST FLORIDA PROSTHETIC CLINIC is a prosthetic orthotic supplier in Fort Myers, FL. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. SOUTHWEST FLORIDA PROSTHETIC CLINIC NPI is 1568596690. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Southwest Florida Prosthetic Clinic.

The provider's business location address is:

13691 METRO PKWY
SUITE 100
FORT MYERS, FL
ZIP 33912-327
Phone: (239) 936-0033
Fax: (239) 936-0047

The provider's authorized official is Gregory Thomas Anerino .
The authorized official title is Certified Anaplastologist and has the following contact phone number (239) 936-0033.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 7/14/2011.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1335E00000XProsthetic/Orthotic SupplierYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10643280001MEDICARE NSCFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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