Organization
BHARTI SUNIL LALLA, MD FAAP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE ELIZABETH NAEGER (OFFICE MANAGER)
(239) 561-2202
Entity
Organization
Contact information
Practice address
14171 METROPOLIS AVE, SUITE 202, FORT MYERS, FL 33912-4335
(239) 561-2202
(239) 561-3099
Mailing address
14171 METROPOLIS AVE, SUITE 202, FORT MYERS, FL 33912-4335
(239) 561-2202
(239) 561-3099
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME061324
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370593500
—
FL
Enumeration date
07/25/2014
Last updated
07/25/2014
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