Provider Demographics
NPI:1679467179
Name:ELEMENT MEDICAL OF CAPE CORAL LLC
Entity type:Organization
Organization Name:ELEMENT MEDICAL OF CAPE CORAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-308-1006
Mailing Address - Street 1:2637 E ATLANTIC BLVD # 1385
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4939
Mailing Address - Country:US
Mailing Address - Phone:239-308-1006
Mailing Address - Fax:239-308-1007
Practice Address - Street 1:822 DEL PRADO BLVD S STE 120
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2687
Practice Address - Country:US
Practice Address - Phone:239-308-1006
Practice Address - Fax:239-308-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty