Provider Demographics
NPI:1013689892
Name:ENT CAPE CORAL LLC
Entity Type:Organization
Organization Name:ENT CAPE CORAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARRANZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-738-9882
Mailing Address - Street 1:1525 SW 52ND TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-7485
Mailing Address - Country:US
Mailing Address - Phone:239-738-9882
Mailing Address - Fax:
Practice Address - Street 1:4202 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7166
Practice Address - Country:US
Practice Address - Phone:239-350-0129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty