MEDICARE: WENDELL FELICIANO D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	DN15085	FL

General Provider Information

NPI Number	:	1598810046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDELL FELICIANO D.D.S.

Provider Business Mailing Address
First Line	:	5659 NAPLES BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-2023
Country	:	US
Telephone Number	:	239-593-2178
Fax Number	:

Provider Business Practice Location Address
First Line	:	5659 NAPLES BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-2023
Country	:	US
Telephone Number	:	239-593-2178
Fax Number	:	239-213-1500

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	02/01/2017

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