Organization
ROYAL PALM MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAZARO GONZALEZ APRN (OWNER)
(239) 313-6300
Entity
Organization
Contact information
Practice address
2665 CLEVELAND AVE STE 102, FORT MYERS, FL 33901-5884
(239) 313-6300
(239) 689-5524
Mailing address
2665 CLEVELAND AVE STE 102, FORT MYERS, FL 33901-5884
(239) 313-6300
(239) 689-5524
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
MM24026
FL
Other
Enumeration date
01/28/2010
Last updated
02/10/2021
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