Organization
INJURY TREATMENT CENTER OF FORT MYERS INC
Active
Other names
Choice Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN SADE (CONSULTANT)
(954) 817-9402
Entity
Organization
Contact information
Practice address
8595 COLLEGE PKWY, SUITE A2, FORT MYERS, FL 33919-5191
(239) 489-2290
(239) 482-6028
Mailing address
2295 NW CORPORATE BLVD, SUITE 140, BOCA RATON, FL 33431-7373
(561) 241-1971
(561) 241-3969
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
HCC6084
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00802
BLUE SHIELD NUMBER
FL
Enumeration date
04/03/2007
Last updated
04/20/2008
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