# INJURY TREATMENT CENTER OF FORT MYERS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Choice Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376664565
- **Authorized official:** EVAN SADE (CONSULTANT)
- **Authorized official phone:** (954) 817-9402

## Contact information

- **Practice address:** 8595 COLLEGE PKWY, SUITE A2, FORT MYERS, FL 33919-5191
- **Practice address phone:** (239) 489-2290
- **Practice address fax:** (239) 482-6028
- **Mailing address:** 2295 NW CORPORATE BLVD, SUITE 140, BOCA RATON, FL 33431-7373
- **Mailing address phone:** (561) 241-1971
- **Mailing address fax:** (561) 241-3969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | HCC6084 | FL | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00802 | BLUE SHIELD NUMBER | FL |