# S.W. FLORIDA PROSTHETIC CLINIC, INC.

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

## Provider details

- **NPI number:** 1598850620
- **Authorized official:** GREGORY T. ANERINO (BOARD CERTIFIED ANAPLASTOLOGIST)
- **Authorized official phone:** (239) 936-0033

## Contact information

- **Practice address:** 13691 METRO PARKWAY, SUITE 100, FT. MYERS, FL 33912
- **Practice address phone:** (239) 936-0033
- **Practice address fax:** (239) 936-0047
- **Mailing address:** 13691 METRO PARKWAY, SUITE 100, FT. MYERS, FL 33912
- **Mailing address phone:** (239) 936-0033
- **Mailing address fax:** (239) 936-0047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1744P3200X | Prosthetics Case Management | — | FL | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 06/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | M6012 | EYE, EAR, NOSE PROSTHETIC | FL |