| Doctor Name: | DR. ERIC ELDON DOUGLASS |
| NPI Number: | 1265490049 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DPT, OCS |
| License Number: | PT7380 |
| Business Practice Address: | 25241 Elementary Way Ste 200 Bonita Springs, FL - 341357883 |
| Business Phone Number: | 2399474184 |
| Business Fax Number: | 2399474171 |
| Mailing Address: | 9920 Colonial Walk S, ESTERO |
| State: | FL |
| Postal Code: | 339286258 |
| Phone Number: | 2399474184 |
| Fax Number: | 2399474171 |
| NPI Enumeration Date: | 05/02/2006 |
| NPI Last Update Date: | 03/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT7380 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |