Organization
S.W. FLORIDA PROSTHETIC CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY T. ANERINO (BOARD CERTIFIED ANAPLASTOLOGIST)
(239) 936-0033
Entity
Organization
Contact information
Practice address
13691 METRO PARKWAY, SUITE 100, FT. MYERS, FL 33912
(239) 936-0033
(239) 936-0047
Mailing address
13691 METRO PARKWAY, SUITE 100, FT. MYERS, FL 33912
(239) 936-0033
(239) 936-0047
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M6012
EYE, EAR, NOSE PROSTHETIC
FL
Enumeration date
10/04/2006
Last updated
06/17/2008
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