MEDICARE: DRQUIT 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
1	207QA0401X	Addiction Medicine (Family Medicine) Physician
2	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1548931991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRQUIT LLC

Provider Business Mailing Address
First Line	:	10676 COLONIAL BLVD STE 30
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8715
Country	:	US
Telephone Number	:	413-438-7848
Fax Number	:	239-256-5307

Provider Business Practice Location Address
First Line	:	10676 COLONIAL BLVD STE 30
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-8715
Country	:	US
Telephone Number	:	708-567-7829
Fax Number	:	239-256-5307

Authorized Official
Title or Position	:	OSTEOPATHIC PHYSICIAN
Name	:	DR. ERIC PATRICK ECK
Credential	:	DO
Telephone Number	:	413-438-7848

Provider Enumeration Date	:	09/24/2021
Last Update Date	:	02/28/2022

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Directions to “DRQUIT LLC ” Practice Location

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