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Organization

EAR NOSE & THROAT INSTITUTE FACIAL SURGERY GROUP PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HAROLD KUSHNER M.D. (PRESIDENT)
(239) 768-7332
Entity
Organization

Contact information

Practice address
13691 METRO PKWY, STE 420, FORT MYERS, FL 33912-4327
(239) 768-7332
(239) 768-2197
Mailing address
PO BOX 7518, FORT MYERS, FL 33911-7518
(239) 931-7262
(239) 931-7397

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME42748
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
040308300
FL
01
DS2037
MEDICARE RAILROAD CARRIER
FL
Enumeration date
04/10/2007
Last updated
06/28/2012
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