| Organization Name: | NORTH CLEVELAND HEALTHCARE CENTER |
| NPI Number: | 1043664469 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAZARO ALFONSO (OFFICE MANAGER) |
| Mailing Address: | 13240 N Cleveland Ave Unit # 9 North Fort Myers |
| State: | FL US |
| Postal Code: | 339034855 |
| Phone Number: | 2396523783 |
| Fax Number: | |
| NPI Enumeration Date: | 04/21/2016 |
| NPI Last Update Date: | 04/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |