Organization
LONGEVITY CENTER OF FORT MYERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL S LEVEQUE AP (VICE PRESIDENT)
(230) 274-6188
Entity
Organization
Contact information
Practice address
12621 NEW BRITTANY BLVD, BLD 17, FORT MYERS, FL 33907-3631
(239) 274-6188
(239) 274-6186
Mailing address
12621 NEW BRITTANY BLVD., BLD 17, FORT MYERS, FL 33907
(239) 274-6188
(239) 274-6186
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP 914
FL
Other
Enumeration date
04/04/2007
Last updated
08/22/2020
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