Provider Demographics
NPI:1811288293
Name:GLADIOLUS MEDICAL CENTER CORP.
Entity type:Organization
Organization Name:GLADIOLUS MEDICAL CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ZAWADA
Authorized Official - Suffix:
Authorized Official - Credentials:CH
Authorized Official - Phone:239-689-5738
Mailing Address - Street 1:8750 GLADIOLUS DR
Mailing Address - Street 2:SUITE # 5
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4165
Mailing Address - Country:US
Mailing Address - Phone:239-689-5738
Mailing Address - Fax:239-689-8041
Practice Address - Street 1:8750 GLADIOLUS DR
Practice Address - Street 2:SUITE # 5
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4165
Practice Address - Country:US
Practice Address - Phone:239-689-5738
Practice Address - Fax:239-689-8041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy