Graduated: 2004
NPI: 1508971037
Practice Locations (2)
10175 6 MILE CYPRESS PKWY, SUITE 3
FORT MYERS, FL 339666993
2397686500
LEGACY HEALTHCARE SERVICES INC
1499 S BRANDYWINE CIR
FORT MYERS, FL 339196775
2392020059
Source: CMS National Downloadable File, September 2026.