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General NPI Number Information
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NPI Number | 1740285287
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Entity Type | Individual
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Provider Name | VALERIE R. DYKE MD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 13770 PLANTATION RD SUITE 2
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City | FORT MYERS
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State | FL
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Zip | 33912-4301
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Country | US
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Telephone | 239-275-0728
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Fax | 239-275-6947
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Provider Business Mailing Address
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Address Line | 2234 COLONIAL BLVD
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | ME0078379
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License Number State | FL
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