Healthcare Provider Details

I. General information

NPI: 1689623704
Provider Name (Legal Business Name): ELIZABETH M EFTHIMIOU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 CLEVELAND AVE
FORT MYERS FL
33901-5858
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-2686
  • Fax: 239-343-3144
Mailing address:
  • Phone: 239-343-2686
  • Fax: 239-343-3144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME133290
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number216577
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: