MEDICARE: STEPHEN F. SCHOLLE MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center	ME0033695	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	90071995	OTHER	FL	MEDICARE RAIL ROAD

General Provider Information

NPI Number	:	1366653081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN F. SCHOLLE MD PA

Provider Business Mailing Address
First Line	:	PO BOX 6970
Second Line	:
City	:	FORT MYERS BEACH
State	:	FL
Zip	:	33932-6970
Country	:	US
Telephone Number	:	239-765-0007
Fax Number	:	239-765-0247

Provider Business Practice Location Address
First Line	:	1661 ESTERO BLVD STE 1
Second Line	:
City	:	FORT MYERS BEACH
State	:	FL
Zip	:	33931-2846
Country	:	US
Telephone Number	:	239-765-0007
Fax Number	:	239-765-0247

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN F SCHOLLE
Credential	:	MD
Telephone Number	:	239-765-0007

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	11/17/2011

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Directions to “STEPHEN F. SCHOLLE MD PA ” Practice Location

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