Healthcare Provider Details

I. General information

NPI: 1437789302
Provider Name (Legal Business Name): NICOLE SATT ANCHETA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2020
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8803 TAMIAMI TRL E
NAPLES FL
34113-3347
US

IV. Provider business mailing address

2328 41ST ST SW
NAPLES FL
34116-6512
US

V. Phone/Fax

Practice location:
  • Phone: 239-351-0675
  • Fax:
Mailing address:
  • Phone: 618-420-4595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: