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Organization

MEDERI OF COLLIER COUNTY, INC.

Active
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Organization

MEDERI OF COLLIER COUNTY, INC.

Active
Other names
Mederi of Port Charlotte
Organization subpart
No

Provider details

NPI number
Authorized official
MR. C. STEVEN GUENTHNER (SR VP, CFO)
(502) 891-1000
Entity
Organization

Contact information

Practice address
2509 RIO DE JANEIRO AVE, SUITE 1, PUNTA GORDA, FL 33983-8667
(941) 764-7555
(941) 764-9533
Mailing address
9510 ORMSBY STATION RD, SUITE 300, LOUISVILLE, KY 40223-4081
(502) 891-1000
(502) 891-8067

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
21996096
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J9I
BLUE CROSS-BLUE SHIELD
FL
Enumeration date
09/26/2005
Last updated
08/22/2020
About Stedi
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