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Organization

PEDIATRIC ENT OF SOUTHWEST FLORIDA PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS J GOTTSCHALK (SOLE PROPRIETOR)
(210) 216-5650
Entity
Organization

Contact information

Practice address
19 GEORGETOWN, FORT MYERS, FL 33919-1088
(210) 216-5650
Mailing address
19 GEORGETOWN, FORT MYERS, FL 33919-1088

Taxonomy

Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary

Other

Enumeration date
05/21/2014
Last updated
05/21/2014
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