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General NPI Number Information
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NPI Number | 1154304087
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY ASSOCIATES OF SOUTHWEST FLORIDA LLC
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 4790 BARKLEY CIR BUILDING A
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City | FT MYERS
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State | FL
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Zip | 33907-7543
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Country | US
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Telephone | 239-275-8882
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Fax | 239-275-6304
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Provider Business Mailing Address
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Address Line | 4790 BARKLEY CIR BUILDING A
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City | FT MYERS
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State | FL
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Zip | 33907-7543
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Country | US
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Telephone | 239-275-8882
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Fax | 239-275-6304
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | NEEKAYTAN SHARMA
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Credential | M.D.
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Telephone | 239-275-8882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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