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General NPI Number Information
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NPI Number | 1821289042
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Entity Type | Organization
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Legal Business Name | GULFSHORE SURGICAL ASSOCIATES PL
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 8340 COLLIER BLVD SUITE #203
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City | NAPLES
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State | FL
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Zip | 34114
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Country | US
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Telephone | 239-774-4275
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Fax | 239-774-4792
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Provider Business Mailing Address
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Address Line | 8340 COLLIER BLVD SUITE #203
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City | NAPLES
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State | FL
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Zip | 34114
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Country | US
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Telephone | 239-774-4275
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Fax | 239-774-4792
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALBERT ANTONIO TITUS
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Credential | M.D.
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Telephone | 239-774-4275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME80817
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License Number State | FL
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