Organization
ISLAND COAST PRIMARY CARE PROJECT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY JONES (PROGRAM ADMINISTRATOR)
(239) 461-8375
Entity
Organization
Contact information
Practice address
4150 FORD STREET EXT STE 1B, FORT MYERS, FL 33916-9498
(239) 467-8375
(239) 461-7639
Mailing address
4150 FORD STREET EXT STE 1B, FORT MYERS, FL 33916-9498
(239) 461-8375
(239) 461-7639
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
3140N1450X
Pediatric Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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