MEDICARE: DIGESTIVE HEALTH PHYSICIANS PL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265412001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGESTIVE HEALTH PHYSICIANS PL

Provider Business Mailing Address
First Line	:	7152 COCA SABAL LN
Second Line	:
City	:	FT MYERS
State	:	FL
Zip	:	33908-4263
Country	:	US
Telephone Number	:	239-939-9939
Fax Number	:	239-931-5078

Provider Business Practice Location Address
First Line	:	7152 COCA SABAL LN
Second Line	:
City	:	FT MYERS
State	:	FL
Zip	:	33908-4263
Country	:	US
Telephone Number	:	239-939-9939
Fax Number	:	239-931-5078

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. PATTI H REIGLE
Credential	:
Telephone Number	:	239-939-9939

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	08/18/2009

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