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General NPI Number Information
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NPI Number | 1144372061
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Entity Type | Organization
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Legal Business Name | EVENHUIS CARDIOLOGY & INTERNAL MEDICINE
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 1351 PINE ST
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City | NAPLES
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State | FL
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Zip | 34104-4260
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Country | US
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Telephone | 239-262-5770
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12018
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City | NAPLES
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State | FL
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Zip | 34101-2018
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Country | US
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Telephone | 239-262-5770
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WALTHER R EVENHUIS
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Credential | M. D.
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Telephone | 239-262-5770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 80066
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 80066
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License Number State | FL
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