Healthcare Provider Details

I. General information

NPI: 1144002080
Provider Name (Legal Business Name): FLORIDA HEALTH CENTERS OF NAPLES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2664 TAMIAMI TRL E
NAPLES FL
34112-5707
US

IV. Provider business mailing address

2664 TAMIAMI TRL E
NAPLES FL
34112-5707
US

V. Phone/Fax

Practice location:
  • Phone: 239-428-1010
  • Fax: 239-734-6342
Mailing address:
  • Phone: 239-428-1010
  • Fax: 239-734-6342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAZARO ROBERTO DIAZ NUNEZ
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 239-428-1010