Organization
SOUTHWEST FLORIDA FACIAL PLASTIC SURGERY ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN A PRENDIVILLE M.D. (PRESIDENT)
(239) 437-3900
Entity
Organization
Contact information
Practice address
9407 CYPRESS LAKE DR STE A, FORT MYERS, FL 33919-0910
(239) 473-7390
Mailing address
9407 CYPRESS LAKE DR STE A, FORT MYERS, FL 33919-0910
(239) 473-7390
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME81906
FL
Other
Enumeration date
10/06/2008
Last updated
05/20/2014
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