Healthcare Provider Details

I. General information

NPI: 1780773218
Provider Name (Legal Business Name): SERGIO NARANJO PSY.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 SURFSIDE BLVD STE 200
CAPE CORAL FL
33914-3861
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-541-7500
  • Fax: 239-541-7501
Mailing address:
  • Phone: 239-541-7500
  • Fax: 239-541-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY10760
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY10760
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: