National Provider Identifier Database

SOUTHWEST FLORIDA FERTILITY CENTER PA
Reproductive Endocrinology

An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.


Contact Information

SOUTHWEST FLORIDA FERTILITY CENTER PA
15730 NEW HAMPSHIRE CT
SUITE 101
FORT MYERS, FL33908
Phone: 239-561-3430
Fax: 239-561-6980
Website:
Specialty Taxonomy Code
* Reproductive Endocrinology 207VE0102X

* Indicates primary specialty

NPI Profile & details for SOUTHWEST FLORIDA FERTILITY CENTER PA

NPI Number 1588749618
Legal business name
LBN
SOUTHWEST FLORIDA FERTILITY CENTER PA
Authorized official JACOB GLOCK - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 10/26/2006
Last updated 01/12/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: ME0057264
  • FL Medicaid: 379285400
  • FL Other: ME0057264 FLORIDA STATE LICENSE

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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