Healthcare Provider Details

I. General information

NPI: 1134409535
Provider Name (Legal Business Name): NAPLES PERITONEAL DIALYSIS CENTER,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

878 109TH AVE N
NAPLES FL
34108-1821
US

IV. Provider business mailing address

878 109TH AVE N
NAPLES FL
34108-1821
US

V. Phone/Fax

Practice location:
  • Phone: 239-596-3044
  • Fax: 239-596-1395
Mailing address:
  • Phone: 239-596-3044
  • Fax: 239-596-1395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. VERA STRICEVIC
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 239-596-3044