Healthcare Provider Details
I. General information
NPI: 1053149310
Provider Name (Legal Business Name): INFINITY HEALTHCARE NORTH NAPLES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3467 PINE RIDGE RD STE 102
NAPLES FL
34109-3832
US
IV. Provider business mailing address
8890 W OAKLAND PARK BLVD STE 200
SUNRISE FL
33351-7221
US
V. Phone/Fax
- Phone: 239-919-6024
- Fax: 754-222-6417
- Phone: 954-741-3304
- Fax: 754-222-6417
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
DI CAPUA
Title or Position: CEO
Credential:
Phone: 561-843-7720