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Organization

CHILDREN'S GASTROENTEROLOGY OF SW FLORIDA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTIAN ROSIORU ROSS M.D. (MEMBER)
(239) 689-5100
Entity
Organization

Contact information

Practice address
9800 S HEALTHPARK DRIVE, SUITE 145, FORT MYERS, FL 33908
(239) 689-5100
Mailing address
9800 S HEALTHPARK DRIVE, SUITE 145, FORT MYERS, FL 33908
(239) 689-5100

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
ME69256
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
253328600
FL
Enumeration date
01/16/2009
Last updated
01/16/2009
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