Organization
RIVERSIDE FAMILY PRACTICE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER LAUTENBACH DO (OWNER)
(239) 694-7887
Entity
Organization
Contact information
Practice address
14651 PALM BEACH BLVD, FORT MYERS, FL 33905-2331
(239) 694-7887
(239) 694-8941
Mailing address
PO BOX 51589, FORT MYERS, FL 33994-1589
(239) 694-7887
(239) 694-8941
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/11/2006
Last updated
02/11/2008
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