Organization
PALM PODIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS RUTHANN PARK PRT, PMAC (PRACTICE ADMINISRTATOR)
(239) 433-0064
Entity
Organization
Contact information
Practice address
15620 MCGREGOR BLVD, SUITE E, FORT MYERS, FL 33908-2528
(239) 433-0064
(239) 433-0224
Mailing address
15620 MCGREGOR BLVD, SUITE E, FORT MYERS, FL 33908-2528
(239) 433-0064
(239) 433-0224
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO1528
FL
Other
Enumeration date
05/03/2006
Last updated
08/22/2020
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