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General NPI Number Information
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NPI Number | 1255436440
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Entity Type | Organization
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Legal Business Name | SIEGEL, HANNAN, & TOLEP M.D.P.A
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9981 S HEALTHPARK DR 279
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City | FORT MYERS
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State | FL
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Zip | 33908-3618
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Country | US
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Telephone | 239-489-1488
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Fax | 239-489-4707
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Provider Business Mailing Address
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Address Line | 9981 S HEALTHPARK DR 279
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City | FORT MYERS
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State | FL
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Zip | 33908-3618
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Country | US
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Telephone | 239-489-1488
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Fax | 239-489-4707
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH ANDREW TOLEP
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Credential | M.D.
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Telephone | 239-489-1488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME0071219
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License Number State | FL
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