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Organization

DERMATOLOGIC AND COSMETIC SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES S EBY MD (MEDICAL DIRECTOR)
(239) 936-1145
Entity
Organization

Contact information

Practice address
2668 SWAMP CABBAGE CT, FORT MYERS, FL 33901-9332
(239) 936-1145
(239) 275-5074
Mailing address
2668 SWAMP CABBAGE CT, FORT MYERS, FL 33901-9332
(239) 936-1145
(239) 275-5074

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ME0015824
FL

Other

Enumeration date
06/22/2006
Last updated
02/04/2013
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