Provider Demographics
NPI:1588682280
Name:DIGESTIVE SPECIALISTS, P.A.
Entity Type:Organization
Organization Name:DIGESTIVE SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-561-7337
Mailing Address - Street 1:530 SE 16TH PL
Mailing Address - Street 2:SUITE B
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1631
Mailing Address - Country:US
Mailing Address - Phone:239-561-7337
Mailing Address - Fax:239-561-0244
Practice Address - Street 1:530 SE 16TH PL
Practice Address - Street 2:SUITE B
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990
Practice Address - Country:US
Practice Address - Phone:239-561-7337
Practice Address - Fax:239-561-0244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57733174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty