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General NPI Number Information
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NPI Number | 1548931991
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Entity Type | Organization
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Legal Business Name | DRQUIT LLC
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Dates
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Enumeration Date | 09/24/2021
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 10676 COLONIAL BLVD STE 30
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City | FORT MYERS
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State | FL
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Zip | 33913-8715
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Country | US
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Telephone | 708-567-7829
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Fax | 239-256-5307
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Provider Business Mailing Address
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Address Line | 10676 COLONIAL BLVD STE 30
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City | FORT MYERS
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State | FL
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Zip | 33913-8715
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Country | US
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Telephone | 413-438-7848
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Fax | 239-256-5307
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Authorized Official
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Title or Position | OSTEOPATHIC PHYSICIAN
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Name | DR. ERIC PATRICK ECK
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Credential | DO
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Telephone | 413-438-7848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) 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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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