Organization
MATERNAL FETAL MEDICINE OF S.W. FL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY MENNA (EXECUTIVE ASSISTANT)
(239) 333-3826
Entity
Organization
Contact information
Practice address
2400 HARBOR BLVD, UNIT 7, PORT CHARLOTTE, FL 33952-5038
(941) 391-8010
(941) 391-8013
Mailing address
8270 COLLEGE PKWY, SUITE 205, FORT MYERS, FL 33919
(239) 333-3826
(239) 333-0592
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Enumeration date
03/21/2011
Last updated
03/21/2011
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