Provider Demographics
NPI:1982920625
Name:LOCUMS DOC INC
Entity Type:Organization
Organization Name:LOCUMS DOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:E
Authorized Official - Last Name:RODI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-218-8760
Mailing Address - Street 1:PO BOX 60055
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33906-6055
Mailing Address - Country:US
Mailing Address - Phone:239-218-8760
Mailing Address - Fax:239-561-3096
Practice Address - Street 1:8772 TROPICAL CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-9240
Practice Address - Country:US
Practice Address - Phone:239-218-8760
Practice Address - Fax:239-561-3096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
80573HMedicare PIN