Provider Demographics
NPI:1356383053
Name:EUGENE BECKER MD, PA
Entity type:Organization
Organization Name:EUGENE BECKER MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-594-2500
Mailing Address - Street 1:PO BOX 112393
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-0141
Mailing Address - Country:US
Mailing Address - Phone:239-594-2500
Mailing Address - Fax:239-593-4902
Practice Address - Street 1:840 111TH AVE N
Practice Address - Street 2:#4
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1877
Practice Address - Country:US
Practice Address - Phone:239-594-2500
Practice Address - Fax:239-593-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 90976207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6974Medicare ID - Type Unspecified