Healthcare Provider Details

I. General information

NPI: 1285177758
Provider Name (Legal Business Name): INTERNAL MEDICINE AND AESTHETICS OF NAPLES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 03/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1726 MEDICAL BLVD SUITE 201
NAPLES FL
34110-1426
US

IV. Provider business mailing address

8805 TAMIAMI TRL N UNIT 105
NAPLES FL
34108-2525
US

V. Phone/Fax

Practice location:
  • Phone: 239-596-8804
  • Fax: 239-596-8793
Mailing address:
  • Phone: 239-699-9499
  • Fax: 239-574-1132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: ALEJANDRO BLANCO-FRANCO
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 239-596-8804