Healthcare Provider Details

I. General information

NPI: 1962310300
Provider Name (Legal Business Name): RESURGENS MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 TAMIAMI TRL E UNIT 301 OFFICE 306
NAPLES FL
34112-5777
US

IV. Provider business mailing address

3080 TAMIAMI TRL E UNIT 301
NAPLES FL
34112-5777
US

V. Phone/Fax

Practice location:
  • Phone: 239-799-3097
  • Fax: 239-508-3064
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. COLE SMITH
Title or Position: CEO
Credential:
Phone: 239-799-3097