| Organization Name: | ESTATES MEDICAL CENTER, INC |
| NPI Number: | 1396182317 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARC E MCCOLLAUM (PRESIDENT) |
| Mailing Address: | 11725 Collier Blvd Ste H Naples |
| State: | FL US |
| Postal Code: | 341166524 |
| Phone Number: | 2393492500 |
| Fax Number: | |
| NPI Enumeration Date: | 05/31/2013 |
| NPI Last Update Date: | 09/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME36001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |