National Provider Identifier Database

MEDICAL CENTRE OF FORT MYERS
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

MEDICAL CENTRE OF FORT MYERS
4901 PALM BEACH BLVD STE 101
FORT MYERS, FL33905-3252
Phone: 813-252-6114
Fax:
Website:
Specialty Taxonomy Code
* General Practice 208D00000X
Addiction Psychiatry 2084P0802X
Adult Mental Health 261QM0850X
Clinic/Center 261Q00000X
Mental Health (Including Community Mental Health Center) 261QM0801X
Methadone 261QM2800X
Primary Care 261QP2300X
Psychologist 103T00000X

* Indicates primary specialty

NPI Profile & details for MEDICAL CENTRE OF FORT MYERS

NPI Number 1356003081
Legal business name
LBN
MEDICAL CENTRE OF FORT MYERS
Authorized official DEMETRIS WEAVER - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 10/11/2021
Last updated 10/20/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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