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General NPI Number Information
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NPI Number | 1932176096
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Entity Type | Organization
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Legal Business Name | GI SPECIALISTS PA
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 8380 RIVERWALK PARK BLVD SUITE 310
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City | FORT MYERS
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State | FL
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Zip | 33919-8758
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Country | US
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Telephone | 239-454-2800
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Fax | 239-454-2808
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Provider Business Mailing Address
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Address Line | PO BOX 60157
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City | FORT MYERS
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State | FL
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Zip | 33906-6157
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Country | US
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Telephone | 239-454-2800
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Fax | 239-454-2808
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Authorized Official
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Title or Position | PROPRIETOR
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Name | DR. MUKUND P. KINI
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Credential | MD
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Telephone | 239-454-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME0055178
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License Number State | FL
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