# IPS OF FT MYERS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558506303
- **Authorized official:** CARL R NOBACK MD (MEMBER)
- **Authorized official phone:** (941) 360-1566

## Contact information

- **Practice address:** 8255 COLLEGE PKWY, ST 100, FORT MYERS, FL 33919-5119
- **Practice address phone:** (888) 337-3509
- **Practice address fax:** (941) 328-3997
- **Mailing address:** 5700 MIDNIGHT PASS RD, ST. 4, SARASOTA, FL 34242-3083
- **Mailing address phone:** (888) 337-3509
- **Mailing address fax:** (941) 328-3997

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 12/09/2008
- **Last updated:** 10/11/2011