| NPI | 1306461447 |
|---|---|
| Former Legal Business Name | ELEVATE MEDICAL FORT MYERS, LLC |
| Entity Type | Organization |
| Authorized Contact | JEREMY MITCHELL Owner 870-919-6686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-06-15 |