Provider Demographics
NPI:1477552669
Name:MESECKE, ERIC ROBERT (RPA)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:ROBERT
Last Name:MESECKE
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 MEDICAL BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1417
Mailing Address - Country:US
Mailing Address - Phone:239-593-3500
Mailing Address - Fax:239-593-9163
Practice Address - Street 1:1706 MEDICAL BLVD STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1417
Practice Address - Country:US
Practice Address - Phone:239-593-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9117376207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW6U113Medicare ID - Type UnspecifiedGROUP
NY4F7841Medicare ID - Type Unspecified
NYP31448Medicare UPIN