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NPI Code Detail

MEDICARE: FLORIDA INCISIONLESS, LLC

MEDICARE: FLORIDA INCISIONLESS, 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
1208600000XSurgery Physician

General Provider Information

NPI Number : 1962794289
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA INCISIONLESS, LLC
Provider Business Mailing Address
First Line : 4881 PALM BEACH BLVD
Second Line : SUITE 100
City : FORT MYERS
State : FL
Zip : 33905-3217
Country : US
Telephone Number : 239-433-3504
Fax Number : 239-693-7369
Provider Business Practice Location Address
First Line : 4881 PALM BEACH BLVD
Second Line : SUITE 100
City : FORT MYERS
State : FL
Zip : 33905-3217
Country : US
Telephone Number : 239-433-3504
Fax Number : 239-693-7369
Authorized Official
Title or Position : SURGEON
Name : DR. PETER MICHAEL DENK
Credential : MD
Telephone Number : 239-433-3504
Provider Enumeration Date : 05/04/2011
Last Update Date : 05/04/2011

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Directions to “FLORIDA INCISIONLESS, LLC ” Practice Location

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