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Organization
ESTERO RETINA
Active
Organization
ESTERO RETINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KARLA KELLAM (ADMINISTRATOR)
(904) 713-2126
Entity
Organization
Contact information
Practice address
9500 CORKSCREW PALMS CIR, ESTERO, FL 33928-3307
(321) 222-3937
Mailing address
8951 BONITA BEACH RD SE STE 525-298, BONITA SPRINGS, FL 34135-4201
(321) 222-3937
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME105560
FL
Other
Enumeration date
09/12/2014
Last updated
09/12/2014
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