Healthcare Provider Details

I. General information

NPI: 1699781401
Provider Name (Legal Business Name): RICHARD SKIBICKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RICK SKIBICKI MD

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 GOODLETTE RD N STE 204
NAPLES FL
34102-5499
US

IV. Provider business mailing address

1112 GOODLETTE RD N STE 204
NAPLES FL
34102-5499
US

V. Phone/Fax

Practice location:
  • Phone: 239-262-4519
  • Fax: 239-262-5672
Mailing address:
  • Phone: 239-262-4519
  • Fax: 239-262-5672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME103469
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35047024
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: