Provider Demographics
NPI:1255436440
Name:SIEGEL, HANNAN, & TOLEP M.D.P.A
Entity type:Organization
Organization Name:SIEGEL, HANNAN, & TOLEP M.D.P.A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:TOLEP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-489-1488
Mailing Address - Street 1:9981 S HEALTHPARK DR
Mailing Address - Street 2:279
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-3618
Mailing Address - Country:US
Mailing Address - Phone:239-489-1488
Mailing Address - Fax:239-489-4707
Practice Address - Street 1:9981 S HEALTHPARK DR
Practice Address - Street 2:279
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3618
Practice Address - Country:US
Practice Address - Phone:239-489-1488
Practice Address - Fax:239-489-4707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071219207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2918Medicare ID - Type UnspecifiedGROUP MEDICARE ID