Provider Demographics
NPI:1346015104
Name:FORT MYERS INFUSION, LLC
Entity Type:Organization
Organization Name:FORT MYERS INFUSION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOKILA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-314-0279
Mailing Address - Street 1:24840 S TAMIAMI TRL STE 1&2
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-7009
Mailing Address - Country:US
Mailing Address - Phone:239-314-0279
Mailing Address - Fax:239-314-0279
Practice Address - Street 1:24840 S TAMIAMI TRL STE 1&2
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-7009
Practice Address - Country:US
Practice Address - Phone:239-314-0279
Practice Address - Fax:239-314-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy