Healthcare Provider Details

I. General information

NPI: 1003115825
Provider Name (Legal Business Name): NEUROSCIENCE AND SPINE ASSOCIATES PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6770 IMMOKALEE ROAD SUITE 111
NAPLES FL
34119
US

IV. Provider business mailing address

6101 PINE RIDGE RD STE 101
NAPLES FL
34119-3900
US

V. Phone/Fax

Practice location:
  • Phone: 239-594-8002
  • Fax: 239-594-3447
Mailing address:
  • Phone: 239-449-3072
  • Fax: 877-334-1886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK B GERBER
Title or Position: PHYSICIAN
Credential: MD
Phone: 239-649-1662