MEDICARE: DR. ERIC P ECK DO

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	208D00000X	General Practice Physician	OS17406	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	:	1790348233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC P ECK DO

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	:	413-438-7848
Fax Number	:	239-256-5307

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2019
Last Update Date	:	02/28/2022

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