Ear Nose & Throat Facial Sugery Center PA

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

ME86099 Issued in FL

Legal business name

EAR NOSE & THROAT FACIAL SUGERY CENTER PA

Practice address

1726 Medical Blvd
Suite 201
Naples, FL 34110-1426

Phone

(239) 594-7774

Fax

(239) 594-5974

NPI assigned

Nov 2, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Carilyn June Malik, MD

Title

President

Phone

(239) 594-7774

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316938806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 MEDICAL BLVD",
            "address_2": "SUITE 201",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101426",
            "telephone_number": "239-594-7774",
            "fax_number": "239-594-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 MEDICAL BLVD",
            "address_2": "SUITE 201",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101426",
            "telephone_number": "239-594-7774",
            "fax_number": "239-594-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE & THROAT FACIAL SUGERY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "CARILYN",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-594-7774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME86099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Naples, FL
• Providers in Naples, FL by specialty
• Otolaryngology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.