Provider Demographics
NPI:1235470477
Name:PREMIER ENDOSCOPY CENTER, LLC
Entity Type:Organization
Organization Name:PREMIER ENDOSCOPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MECKSTROTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-732-1133
Mailing Address - Street 1:1656 MEDICAL BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1423
Mailing Address - Country:US
Mailing Address - Phone:239-732-1133
Mailing Address - Fax:
Practice Address - Street 1:1656 MEDICAL BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1423
Practice Address - Country:US
Practice Address - Phone:239-732-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty