Healthcare Provider Details

I. General information

NPI: 1568558138
Provider Name (Legal Business Name): DREW HORLBECK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9711 COMMERCE CENTER CT STE 101
FORT MYERS FL
33908-3817
US

IV. Provider business mailing address

9711 COMMERCE CENTER CT STE 101
FORT MYERS FL
33908-3817
US

V. Phone/Fax

Practice location:
  • Phone: 239-939-2621
  • Fax: 239-939-3875
Mailing address:
  • Phone: 239-939-2621
  • Fax: 239-939-3875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberME99151
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME99151
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: