| Zion Healing Center Fort Myers | |
|
9405 Cypress Lake Dr Ste 2 Fort Myers FL 33919-0909 | |
| (239) 372-6141 | |
| (239) 936-3391 |
| Full Name | Zion Healing Center Fort Myers |
|---|---|
| Speciality | Clinic/Center |
| Location | 9405 Cypress Lake Dr Ste 2, Fort Myers, Florida |
| Authorized Official Name and Position | Edna Muchugu (MANAGER) |
| Authorized Official Contact | 2393726141 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Zion Healing Center Fort Myers 9405 Cypress Lake Dr Ste 2 Fort Myers FL 33919-0909 Ph: (239) 946-6538 | Zion Healing Center Fort Myers 9405 Cypress Lake Dr Ste 2 Fort Myers FL 33919-0909 Ph: (239) 372-6141 |
| NPI Number | 1609501428 |
|---|---|
| Provider Enumeration Date | 07/18/2022 |
| Last Update Date | 06/28/2023 |
| Certification Date | 06/28/2023 |
| Medicare PECOS PAC ID | 1052774528 |
|---|---|
| Medicare Enrollment ID | O20230831000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609501428 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
| Provider Name | Chadd K Eaglin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750599833 PECOS PAC ID: 9032381181 Enrollment ID: I20160225002528 |
| Provider Name | Christopher Zeoli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477595114 PECOS PAC ID: 1557364148 Enrollment ID: I20201217000277 |
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