Healthcare Provider Details

I. General information

NPI: 1659023240
Provider Name (Legal Business Name): ESSCO NAPLES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 BONITA BEACH RD SE STE 204
BONITA SPRINGS FL
34135-4520
US

IV. Provider business mailing address

2338 IMMOKALEE RD # 203
NAPLES FL
34110-1445
US

V. Phone/Fax

Practice location:
  • Phone: 239-422-6020
  • Fax:
Mailing address:
  • Phone: 239-919-4342
  • Fax: 239-919-4342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MARCI CHARLAND
Title or Position: ADMIN
Credential:
Phone: 239-919-4342