Healthcare Provider Details

I. General information

NPI: 1982920625
Provider Name (Legal Business Name): LOCUMS DOC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 04/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8772 TROPICAL CT
FORT MYERS FL
33908-9240
US

IV. Provider business mailing address

PO BOX 60055
FORT MYERS FL
33906-6055
US

V. Phone/Fax

Practice location:
  • Phone: 239-218-8760
  • Fax: 239-561-3096
Mailing address:
  • Phone: 239-218-8760
  • Fax: 239-561-3096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDER E RODI
Title or Position: MANAGING MEMBER
Credential: DO
Phone: 239-218-8760