Provider Demographics
NPI:1326822123
Name:TMS AND KETAMINE CLINIC OF SW FLORIDA LLC
Entity type:Organization
Organization Name:TMS AND KETAMINE CLINIC OF SW FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAHEER
Authorized Official - Middle Name:
Authorized Official - Last Name:ASLAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-935-5599
Mailing Address - Street 1:6700 WINKLER RD STE 8
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-7237
Mailing Address - Country:US
Mailing Address - Phone:239-935-5599
Mailing Address - Fax:239-313-5614
Practice Address - Street 1:6700 WINKLER RD STE 8
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-7237
Practice Address - Country:US
Practice Address - Phone:239-935-5599
Practice Address - Fax:239-313-5614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty