Organization
COGENT HEALTHCARE OF FORT MYERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN A. BROWNIE (TREASURER)
(615) 377-5630
Entity
Organization
Contact information
Practice address
2776 CLEVELAND AVE, CARE MANAGEMENT DEPARTMENT, 8TH FLOOR, FT MYERS, FL 33901-5864
(239) 344-5837
Mailing address
5410 MARYLAND WAY, SUITE 300, BRENTWOOD, TN 37027-5064
(615) 377-5670
(615) 377-1687
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266101200
—
FL
01
—
34480
BLUE CROSS BLUE SHEILD FL
FL
Enumeration date
05/12/2006
Last updated
07/21/2008
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