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FT MYERS PHYSICIAN PA NPI 1437209855


NPI Information

NPI: 1437209855
Provider Name: FT MYERS PHYSICIAN PA
Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Address:
2721 DEL PRADO BLVD S
SUITE 240
CAPE CORAL, FL
ZIP 33904
Phone: (239) 333-0084
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FT MYERS PHYSICIAN PA is an emergency medicine in Cape Coral, FL. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. FT MYERS PHYSICIAN PA NPI is 1437209855. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2721 DEL PRADO BLVD S
SUITE 240
CAPE CORAL, FL
ZIP 33904-781
Phone: (239) 333-0084
Fax: (239) 333-0086

The provider's authorized official is Dana Gerald Killam .
The authorized official title is President and has the following contact phone number (239) 333-0084.

The enumeration date for this NPI number is 1/10/2007 and was last updated on 4/20/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency MedicineME36712FLORIDAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
139207MEDICARE PINFLORIDA
2D52154MEDICARE UPINFLORIDA
3=========OTHERFLORIDATAX ID

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: 4/28/2024

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