Healthcare Provider Details

I. General information

NPI: 1295000545
Provider Name (Legal Business Name): DEBORAH A. C. HOUK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 06/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 PINE RIDGE RD
NAPLES FL
34119
US

IV. Provider business mailing address

6101 PINE RIDGE RD
NAPLES FL
34119-3900
US

V. Phone/Fax

Practice location:
  • Phone: 239-304-4771
  • Fax:
Mailing address:
  • Phone: 239-304-4771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number304118
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME134333
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: