Organization
EAR, NOSE & THROAT HEALTH CENTER,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLAWALE O IDEWU M.D. (OWNER)
(941) 235-2131
Entity
Organization
Contact information
Practice address
103 W MARION AVE, PUNTA GORDA, FL 33950-4403
(941) 205-5555
(941) 205-5558
Mailing address
103 W MARION AVE, PUNTA GORDA, FL 33950-4403
(941) 205-5555
(941) 205-5558
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME80223
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262489300
—
FL
Enumeration date
09/26/2006
Last updated
08/23/2012
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