Organization
SYPERT INSTITUTE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT O GRADY (VICE PRESIDENT)
(239) 432-0774
Entity
Organization
Contact information
Practice address
632 DEL PRADO BLVD N, SUITE 101, CAPE CORAL, FL 33909-2278
(239) 772-5577
(239) 772-8879
Mailing address
632 DEL PRADO BLVD N, SUITE 101, CAPE CORAL, FL 33909-2253
(239) 772-5577
(239) 772-9961
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3792099-00
—
FL
Enumeration date
04/07/2006
Last updated
08/05/2014
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