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Individual

EDWARD MICHAELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 275-3222
Mailing address
201 LEELAND HEIGHTS BLVD E, LEHIGH ACRES, FL 33936-6714
(239) 839-4598

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171MOOOOOX
FL
Enumeration date
02/10/2017
Last updated
02/10/2017
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