MEDICARE: DR. CAROLYN BETH MESSERE MD

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	208D00000X	General Practice Physician	ME93472	FL

General Provider Information

NPI Number	:	1700878642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLYN BETH MESSERE MD

Provider Business Mailing Address
First Line	:	4280 TAMIAMI TRL E STE 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34112-6705
Country	:	US
Telephone Number	:	239-774-5433
Fax Number	:	239-774-5409

Provider Business Practice Location Address
First Line	:	4280 TAMIAMI TRL E STE 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34112-6705
Country	:	US
Telephone Number	:	239-774-5433
Fax Number	:	239-774-5409

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	04/21/2020

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