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Organization
IPS OF FT MYERS LLC
Active
Organization
IPS OF FT MYERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL R NOBACK MD (MEMBER)
(941) 360-1566
Entity
Organization
Contact information
Practice address
8255 COLLEGE PKWY, ST 100, FORT MYERS, FL 33919-5119
(888) 337-3509
(941) 328-3997
Mailing address
5700 MIDNIGHT PASS RD, ST. 4, SARASOTA, FL 34242-3083
(888) 337-3509
(941) 328-3997
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
12/09/2008
Last updated
10/11/2011
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