Healthcare Provider Details

I. General information

NPI: 1104001353
Provider Name (Legal Business Name): DREW MEDICAL ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11181 HEALTH PARK BLVD SUITE 3000
NAPLES FL
34110-5738
US

IV. Provider business mailing address

11181 HEALTH PARK BLVD SUITE 3000
NAPLES FL
34110-5738
US

V. Phone/Fax

Practice location:
  • Phone: 239-598-5755
  • Fax: 239-430-5559
Mailing address:
  • Phone: 239-598-5755
  • Fax: 239-430-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME71611
License Number StateFL

VIII. Authorized Official

Name: DANIEL J DREW
Title or Position: PRESIDENT
Credential: MD
Phone: 239-598-5755