Healthcare Provider Details

I. General information

NPI: 1356383053
Provider Name (Legal Business Name): EUGENE BECKER MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 111TH AVE N #4
NAPLES FL
34108-1877
US

IV. Provider business mailing address

PO BOX 112393
NAPLES FL
34108-0141
US

V. Phone/Fax

Practice location:
  • Phone: 239-594-2500
  • Fax: 239-593-4902
Mailing address:
  • Phone: 239-594-2500
  • Fax: 239-593-4902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME 90976
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME 90976
License Number StateFL

VIII. Authorized Official

Name: EUGENE BECKER
Title or Position: OWNER
Credential: MD
Phone: 239-594-2500