Organization
AZUL COSMETIC SURGERY & MEDICAL SPA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK FLAHARTY MD (OWNER)
(239) 415-7576
Entity
Organization
Contact information
Practice address
13470 PARKER COMMONS BLVD, SUITE 101, FORT MYERS, FL 33912-1809
(239) 415-7576
Mailing address
PO BOX 07339, FORT MYERS, FL 33919-0339
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME63087
FL
208200000X
Plastic Surgery Physician
ME63087
FL
Other
Enumeration date
07/10/2006
Last updated
07/16/2008
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