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Organization
SKILLED NURSING CARE MEDICAL GROUP LLC
Active
Organization
SKILLED NURSING CARE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID KOENINGER (CFO)
(855) 674-7400
Entity
Organization
Contact information
Practice address
2335 AARON ST, PORT CHARLOTTE, FL 33952-5305
(855) 670-7400
(855) 674-7401
Mailing address
3434 HANCOCK BRIDGE PKWY, STE 301, NORTH FORT MYERS, FL 33903-7094
(877) 856-3774
(239) 599-2625
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
07/16/2014
Last updated
08/01/2014
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