Healthcare Provider Details

I. General information

NPI: 1164139432
Provider Name (Legal Business Name): BARBARA CASIMIR RN/ ADMINISTRATOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2977 GOODLETTE-FRANK RD N STE 1
NAPLES FL
34103-4613
US

IV. Provider business mailing address

2977 GOODLETTE-FRANK RD N STE 1
NAPLES FL
34103-4613
US

V. Phone/Fax

Practice location:
  • Phone: 239-331-3548
  • Fax: 239-842-6182
Mailing address:
  • Phone: 239-331-3548
  • Fax: 239-842-6182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN9422161
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number30212294
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number30212294
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: