Organization
HEALTHWISE MEDICAL PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE MARTIN MD (PHYSICIAN)
(646) 267-6718
Entity
Organization
Contact information
Practice address
1415 COLONIAL BLVD, FORT MYERS, FL 33907-1043
(239) 202-4517
Mailing address
8140 LIRIOPE LOOP, LEHIGH ACRES, FL 33972-7546
(646) 267-6718
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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