Healthcare Provider Details

I. General information

NPI: 1023025731
Provider Name (Legal Business Name): STEPHEN F SCHOLLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 12/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 ESTERO BLVD STE 1
FORT MYERS BEACH FL
33931-2846
US

IV. Provider business mailing address

PO BOX 6970
FORT MYERS BEACH FL
33932
US

V. Phone/Fax

Practice location:
  • Phone: 239-765-0007
  • Fax: 239-765-0247
Mailing address:
  • Phone: 239-765-0007
  • Fax: 239-765-0247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME 0033695
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: