Healthcare Provider Details

I. General information

NPI: 1699625491
Provider Name (Legal Business Name): MEDIANA PIERRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11665 COLLIER BLVD UNIT 990898
NAPLES FL
34116-4249
US

IV. Provider business mailing address

11665 COLLIER BLVD UNIT 990898
NAPLES FL
34116-4249
US

V. Phone/Fax

Practice location:
  • Phone: 239-484-9871
  • Fax:
Mailing address:
  • Phone: 239-484-9871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN9440235
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN9440235
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN9440235
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9440235
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN9440235
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: