Organization
PRP CENTERS OF FLORIDA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNEH BACKSTRAND (MD)
(239) 338-7074
Entity
Organization
Contact information
Practice address
1225 SUNBURY DR, FORT MYERS, FL 33901-8738
(239) 338-7074
Mailing address
1225 SUNBURY DR, FORT MYERS, FL 33901-8738
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ME0050622
FL
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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