Healthcare Provider Details

I. General information

NPI: 1063952828
Provider Name (Legal Business Name): PAUL NJERU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2752 FOUNTAIN VIEW CIR 103
NAPLES FL
34109-2723
US

IV. Provider business mailing address

2752 FOUNTAIN VIEW CIR 103
NAPLES FL
34109-2723
US

V. Phone/Fax

Practice location:
  • Phone: 574-323-8853
  • Fax:
Mailing address:
  • Phone: 574-323-8853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9374818
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9374818
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: