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NPI Code Detail

MEDICARE: EPN URGENT CARE LLC

MEDICARE: EPN URGENT CARE LLC
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
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
194800OTHERFLBCFL

General Provider Information

NPI Number : 1275624579
Entity Type Code : Organization
Provider Name (Legal Business Name) : EPN URGENT CARE LLC
Provider Business Mailing Address
First Line : 1112 GOODLETTE RD N
Second Line : SUITE 204
City : NAPLES
State : FL
Zip : 34102-5497
Country : US
Telephone Number : 888-311-8760
Fax Number :
Provider Business Practice Location Address
First Line : 6400 DAVIS BLVD
Second Line :
City : NAPLES
State : FL
Zip : 34104-5321
Country : US
Telephone Number : 239-455-6300
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JOHN P LEWIS
Credential : MD
Telephone Number : 239-262-4519
Provider Enumeration Date : 09/28/2006
Last Update Date : 10/23/2008

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Directions to “EPN URGENT CARE LLC ” Practice Location

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