# ELEVATE MEDICAL FORT MYERS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elevate Medical Fort Myers, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306461447
- **Authorized official:** JEREMY MITCHELL BSN (OWNER)
- **Authorized official phone:** (870) 919-6686

## Contact information

- **Practice address:** 1850 BOY SCOUT DR STE A102, FORT MYERS, FL 33907-2127
- **Practice address phone:** (870) 919-6686
- **Practice address fax:** (662) 560-0161
- **Mailing address:** 1850 BOY SCOUT DR STE A102, FORT MYERS, FL 33907-2127
- **Mailing address phone:** (662) 501-0043
- **Mailing address fax:** (662) 560-0161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/15/2020
- **Last updated:** 06/15/2020