DERMATOLOGIC AND COSMETIC SURGERY NPI 1053347203

NPI Information

NPI: 1053347203
Provider Name: DERMATOLOGIC AND COSMETIC SURGERY
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
2668 SWAMP CABBAGE CT
FORT MYERS, FL
ZIP 33901
Phone: (239) 936-1145
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DERMATOLOGIC AND COSMETIC SURGERY is an ambulatory surgical clinic center in Fort Myers, FL. DERMATOLOGIC AND COSMETIC SURGERY NPI is 1053347203. The provider is registered as an organization entity type.

The provider's business location address is:

2668 SWAMP CABBAGE CT
FORT MYERS, FL
ZIP 33901-332
Phone: (239) 936-1145
Fax: (239) 275-5074

The provider's authorized official is Charles S Eby .
The authorized official title is Medical Director and has the following contact phone number (239) 936-1145.

The enumeration date for this NPI number is 6/22/2006 and was last updated on 2/4/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	ME0015824	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	K7316	MEDICARE PIN	FLORIDA
2	F1075	MEDICARE PIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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