Organization
KENNETH W. BACKSTRAND & ASSOCIATES, MD,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICE BURNS (BILLING ADMIN)
(239) 418-1004
Entity
Organization
Contact information
Practice address
2721 DEL PRADO BLVD, STE 100, CAPE CORAL, FL 33904
(239) 242-8010
(239) 242-8020
Mailing address
PO BOX 60719, FORT MYERS, FL 33906
(239) 418-1004
(239) 275-9080
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME0050622
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046206300
—
FL
Enumeration date
08/04/2006
Last updated
10/23/2009
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