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Organization
FLORIDA GULF COAST UNIVERISTY
Active
Organization
FLORIDA GULF COAST UNIVERISTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA NECOLE NEAL LAT (ASST. AD FOR HEALTH PERFORMANCE)
(239) 745-4299
Entity
Organization
Contact information
Practice address
10501 FGCU BLVD S, FORT MYERS, FL 33965-6502
(239) 742-4299
(239) 590-7398
Mailing address
10501 FGCU BLVD S, FORT MYERS, FL 33965-6502
(239) 742-4299
(239) 590-7398
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
2255A2300X
Athletic Trainer
—
NULL
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
07/22/2020
Last updated
09/29/2020
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