Organization
DUXANA MEDICAL CENTER CORP
Active
Other names
Integrated Care Centers
Organization subpart
No
Provider details
NPI number
Authorized official
FARID MUSTAFA (PARTNER OWNER)
(239) 208-2790
Entity
Organization
Contact information
Practice address
5248 RED CEDAR DR STE 102, FORT MYERS, FL 33907-4522
(239) 208-2790
Mailing address
5248 RED CEDAR DR STE 102, FORT MYERS, FL 33907-4522
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
12/16/2019
Last updated
12/16/2019
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