=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366889669
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GI SURGICAL SPECIALISTS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/28/2013
-----------------------------------------------------
Last Update Date | 05/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14131 METROPOLIS AVE STE 101
-----------------------------------------------------
City | FORT MYERS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33912-4455
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-313-7522
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14131 METROPOLIS AVE STE 101
-----------------------------------------------------
City | FORT MYERS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33912-4455
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-313-7522
-----------------------------------------------------
Fax | 239-244-9957
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. PETER M DENK
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 239-313-7522
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | ME94691
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------