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NPI Code Detail

MEDICARE: EAR NOSE & THROAT FACIAL SUGERY CENTER PA

MEDICARE: EAR NOSE & THROAT FACIAL SUGERY CENTER PA
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
1207Y00000XOtolaryngology PhysicianME86099FL

General Provider Information

NPI Number : 1316938806
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAR NOSE & THROAT FACIAL SUGERY CENTER PA
Provider Business Mailing Address
First Line : 1726 MEDICAL BLVD
Second Line : SUITE 201
City : NAPLES
State : FL
Zip : 34110-1426
Country : US
Telephone Number : 239-594-7774
Fax Number : 239-594-5974
Provider Business Practice Location Address
First Line : 1726 MEDICAL BLVD
Second Line : SUITE 201
City : NAPLES
State : FL
Zip : 34110-1426
Country : US
Telephone Number : 239-594-7774
Fax Number : 239-594-5974
Authorized Official
Title or Position : PRESIDENT
Name : DR. CARILYN JUNE MALIK
Credential : MD
Telephone Number : 239-594-7774
Provider Enumeration Date : 11/02/2005
Last Update Date : 08/22/2020

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Directions to “EAR NOSE & THROAT FACIAL SUGERY CENTER PA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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