EXCELLENCE MEDICAL CENTERS,LLC
Osteopathic Medicine at 16 Pl, Cape Coral, FL

License number
Florida ME94225
Category
Osteopathic Medicine
Type
General Practice
Owner
Name: CHRISTINE MACKIE M.D.
Title: OWNER
Phone: (239) 540-0800
Address
Address
4406 SE 16Th Pl STE 104, Cape Coral, FL 33904
National Provider ID: 1629388319
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EXCELLENCE MEDICAL CENTERS, LLC

Cape Coral, FL

Status:
Inactive
Inactive reason:
REINSTATEMENT
Registration:
Jun 1, 2010
Inactive since:
Feb 28, 2012
Addresses:
4304 Del Prado Blvd S, Cape Coral, FL 33904 (Physical)
4406 SE 16 Pl, Cape Coral, FL 33904
State ID:
L10000058154
Business type:
Florida Limited Liability Company
Managing Members:
Christine M Mackie (Managing Member), 4304 Del Prado Blvd S, Cape Coral, FL 33904 (Physical),Erisdel Martinez Managing Member, inactive
Agent:
Christine Mackie,4304 Del Prado Blvd S, Cape Coral, FL 33904 (Physical)
EIN:
272731289

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