Healthcare Provider Details

I. General information

NPI: 1447503461
Provider Name (Legal Business Name): NEPHROLOGY INSTITUTE OF NAPLES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 GOODLETTE RD N
NAPLES FL
34102-5469
US

IV. Provider business mailing address

671 GOODLETTE RD N
NAPLES FL
34102-5469
US

V. Phone/Fax

Practice location:
  • Phone: 239-860-6965
  • Fax:
Mailing address:
  • Phone: 239-860-6965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME94388
License Number StateFL

VIII. Authorized Official

Name: VERA STRICEVIC
Title or Position: OWNER
Credential: MD
Phone: 239-860-6965