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Organization
INJURY TREATMENT CENTER OF FORT MYERS INC
Active
Organization
INJURY TREATMENT CENTER OF FORT MYERS INC
Active
Other names
Choice Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN SADE (CONSULTANT)
(954) 817-9402
Entity
Organization
Contact information
Practice address
8595 COLLEGE PKWY, SUITE A2, FORT MYERS, FL 33919-5191
(239) 489-2290
(239) 482-6028
Mailing address
2295 NW CORPORATE BLVD, SUITE 140, BOCA RATON, FL 33431-7373
(561) 241-1971
(561) 241-3969
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
HCC6084
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00802
BLUE SHIELD NUMBER
FL
Enumeration date
04/03/2007
Last updated
04/20/2008
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