Provider Demographics
NPI:1023433984
Name:PHYSICIANS FOR QUALITY HEALTHCARE, INC.
Entity type:Organization
Organization Name:PHYSICIANS FOR QUALITY HEALTHCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GHANEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-768-6396
Mailing Address - Street 1:6150 DIAMOND CENTRE CT
Mailing Address - Street 2:BLDG 100
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912
Mailing Address - Country:US
Mailing Address - Phone:239-768-6396
Mailing Address - Fax:239-204-3000
Practice Address - Street 1:6444 BEACH BLVD STE 200
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2891
Practice Address - Country:US
Practice Address - Phone:239-768-6396
Practice Address - Fax:239-204-3000
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICIANS FOR QUALITY HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-28
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty