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Organization

WITTENBORN PLASTIC SURGERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WILLIAM SCOTT WITTENBORN M.D. (OWNER)
(239) 561-2313
Entity
Organization

Contact information

Practice address
14131 METROPOLIS AVE STE 105, FORT MYERS, FL 33912-4332
(239) 561-2313
(888) 500-2420
Mailing address
13300 S CLEVELAND AVE STE 56, #261, FORT MYERS, FL 33907-3871
(239) 561-2313
(888) 500-2420

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
87881
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
71645X
MEDICARE
FL
Enumeration date
07/15/2008
Last updated
05/06/2009
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