Provider Demographics
NPI:1427358035
Name:NEUROPATHY MEDICAL CENTER OF FLORIDA
Entity Type:Organization
Organization Name:NEUROPATHY MEDICAL CENTER OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-275-7575
Mailing Address - Street 1:13700 CYPRESS TERRACE CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-8819
Mailing Address - Country:US
Mailing Address - Phone:239-275-7575
Mailing Address - Fax:239-275-7304
Practice Address - Street 1:13700 CYPRESS TERRACE CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-8819
Practice Address - Country:US
Practice Address - Phone:239-275-7575
Practice Address - Fax:239-275-7304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9899261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty