Healthcare Provider Details

I. General information

NPI: 1104877307
Provider Name (Legal Business Name): JOHN N TROBAUGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 05/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 PINE RIDGE RD
NAPLES FL
34119-3900
US

IV. Provider business mailing address

6101 PINE RIDGE RD
NAPLES FL
34119-3900
US

V. Phone/Fax

Practice location:
  • Phone: 239-348-4000
  • Fax: 239-304-5157
Mailing address:
  • Phone: 239-304-4862
  • Fax: 239-304-5157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberFLME0083105
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: