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Individual

POONAM POONAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11215 METRO PKWY STE 100, FORT MYERS, FL 33966-1206
(239) 208-2212
(239) 208-3994
Mailing address
1665 HERLONG COURT, STE B, ROCK HILL, SC 29732
(803) 366-6135
(803) 366-3439

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
272359
MA
2084N0400X
Neurology Physician
2024049374
MO
2084N0400X
Neurology Physician
MD223261
OR
2084N0400X
Neurology Physician
MD61627497
WA
2084N0400X
Neurology Physician
Primary
ME171316
FL
2084N0400X
Neurology Physician
TP578
KY

Other

Enumeration date
07/01/2017
Last updated
04/24/2025
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