PHYSICIANS MEDICAL GROUP OF SOUTHWEST FLORIDA,LLC
Marriage and Family Therapists at Colonial Blvd, Fort Myers, FL

License number
Florida OS002373
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: ALFONSE J PICCOLA D.O.
Title: MANAGER
Phone: (239) 936-1233
Address
Address
3880 Colonial Blvd SUITE 1A, Fort Myers, FL 33966
National Provider ID: 1104259035
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PHYSICIANS MEDICAL GROUP OF SOUTHWEST FLORIDA, LLC

Fort Myers, FL

Registration:
Jul 15, 2013
Addresses:
3880 Colonial Blvd 1A, Fort Myers, FL 33966 (Physical)
3880 Colonial Blvd, Fort Myers, FL 33966
State ID:
L13000100051
Business type:
Florida Limited Liability Company
S:
Piccola, A. Joseph, Dr, 3880 Colonial Blvd 1A, Fort Myers, FL 33966 (Physical),Rhonda Sievert, 3880 Colonial Blvd, Fort Myers, FL 33966 (Physical),A. Joseph D Piccola
Agent:
Thomas, Thomas D, Dr,3880 Colonial Blvd, Fort Myers, FL 33966 (Physical)
EIN:
46-3215567

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