Organization
MINK OF LEE COUNTY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CORAZON DENONTEVERDE BURIAS (ADMINISTRATOR)
(239) 574-8789
Entity
Organization
Contact information
Practice address
825 SANTA BARBARA BLVD., CAPE CORAL, FL 33995
(239) 574-8789
Mailing address
825 SANTA BARBARA BLVD., CAPE CORAL, FL 33995
(239) 574-8789
(239) 574-1883
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2651042
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2651042
R.N.
FL
Enumeration date
11/30/2012
Last updated
11/30/2012
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