Organization
AXEL MEDICAL GROUP LLC
Active
Organization
AXEL MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSELL LLORENTE (DIRECTOR OF CREDENTIALING)
(239) 223-8129
Entity
Organization
Contact information
Practice address
6811 PORTO FINO CIR, FORT MYERS, FL 33912-4354
(239) 208-6648
(855) 462-3008
Mailing address
4820 GRIFFIN BLVD, FORT MYERS, FL 33908-2016
(239) 208-6648
(855) 462-3008
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
04/28/2023
Last updated
09/19/2023
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