Provider Demographics
NPI:1295762532
Name:EVERETT H ALSBROOK JR MD PA
Entity type:Organization
Organization Name:EVERETT H ALSBROOK JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVERETT
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:ALSBROOK
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:239-261-8007
Mailing Address - Street 1:680 2ND AVE N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5753
Mailing Address - Country:US
Mailing Address - Phone:239-261-8007
Mailing Address - Fax:239-261-3275
Practice Address - Street 1:680 2ND AVE N
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5753
Practice Address - Country:US
Practice Address - Phone:239-261-8007
Practice Address - Fax:239-261-3275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37760207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
11128Medicare ID - Type Unspecified
D52119Medicare UPIN