Provider Demographics
NPI:1144597881
Name:SPECIALISTS IN REPRODUCTIVE MEDICINE & SURGERY, P.A.
Entity Type:Organization
Organization Name:SPECIALISTS IN REPRODUCTIVE MEDICINE & SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:R
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-275-8118
Mailing Address - Street 1:12611 WORLD PLAZA LN
Mailing Address - Street 2:BUILDING 53
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3990
Mailing Address - Country:US
Mailing Address - Phone:239-275-8118
Mailing Address - Fax:239-275-5914
Practice Address - Street 1:12611 WORLD PLAZA LN
Practice Address - Street 2:BUILDING 53
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3990
Practice Address - Country:US
Practice Address - Phone:239-275-8118
Practice Address - Fax:239-275-5914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060184207VE0102X
FLARNP9207683363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL56529600Medicaid
FLE94136Medicare UPIN