PSYCHIATRIC ASSOCIATES OF SOUTHWEST FLORIDA, PLLC
Psychiatric at Porto Fino Cir, Fort Myers, FL

License number
Florida ME26270
Category
Psychiatric
Type
Psychiatry
Owner
Name: MISS NICOLE L ORTIZ
Title: CHIEF OPERATING OFFICER
Phone: (239) 332-4700
Address
Address
6804 Porto Fino Cir SUITE 1, Fort Myers, FL 33912
National Provider ID: 1225309552
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PSYCHIATRIC ASSOCIATES OF SOUTHWEST FLORIDA PLLC

Fort Myers, FL

Industry:
Health Practitioner's Office, Offices of Health Practitioners, Nsk
Doing business as:
Psychiatric Associates of Southwest Florida
Registration:
Nov 22, 2011
Addresses:
6804 Porto Fino Cir, Fort Myers, FL 33912 (Physical)
17781 Via Bella Acqua Ct, Fort Myers, FL 33913
State ID:
L11000132802
Business type:
Florida Limited Liability Company
Office Manager, Principals:
Robert W Pollack (Managing Member), 17781 Via Bella Acqua Ct APT 1003, Fort Myers, FL 33913 (Physical),Nicole L. Ortiz (Office Manager, Principal)
Agent:
Pollack, Pam,17781 Via Bella Acqua Ct APT 1003, Fort Myers, FL 33913 (Physical)
EIN:
45-3973727

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