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1649233545
RIVERSIDE FAMILY PRACTICE PA
FORT MYERS, FL
NPI
1649233545
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Entity Type
Organization
Authorized Contact
PETER LAUTENBACH
Owner
239-694-7887
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
Enumeration Date
2006-04-11
Last Update Date
2008-02-11
Business Address
RIVERSIDE FAMILY PRACTICE PA
14651 PALM BEACH BLVD
FORT MYERS, FL 33905-2331
Phone number: 239-694-7887
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Mailing Address
RIVERSIDE FAMILY PRACTICE PA
PO BOX 51589
FORT MYERS, FL 33994-1589
Phone number: 239-694-7887
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