Healthcare Provider Details

I. General information

NPI: 1811099104
Provider Name (Legal Business Name): AMER SKOPIC D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 SE 8TH TER
CAPE CORAL FL
33990-3306
US

IV. Provider business mailing address

10 GLENLAKE PKWY STE 900
ATLANTA GA
30328-7249
US

V. Phone/Fax

Practice location:
  • Phone: 239-458-0822
  • Fax:
Mailing address:
  • Phone: 404-888-7575
  • Fax: 404-253-6896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number052786
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: