Provider Demographics
NPI:1558721936
Name:ASSOCIATES IN MEDICINE & SURGERY LLC
Entity Type:Organization
Organization Name:ASSOCIATES IN MEDICINE & SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:H
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHARARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-689-8900
Mailing Address - Street 1:11821 PALM BEACH BLVD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-5908
Mailing Address - Country:US
Mailing Address - Phone:239-693-6565
Mailing Address - Fax:239-693-0006
Practice Address - Street 1:11821 PALM BEACH BLVD
Practice Address - Street 2:SUITE 124
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-5908
Practice Address - Country:US
Practice Address - Phone:239-693-6565
Practice Address - Fax:239-693-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207LP2900X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty