Healthcare Provider Details

I. General information

NPI: 1619997608
Provider Name (Legal Business Name): ROCCO J SANTARELLI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 02/01/2020
Certification Date: 02/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 9TH ST N STE 100
NAPLES FL
34102-5886
US

IV. Provider business mailing address

311 9TH ST N STE 100
NAPLES FL
34102-5886
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-8250
  • Fax: 239-624-8251
Mailing address:
  • Phone: 239-624-8250
  • Fax: 239-624-8251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberOS15753
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberOS006510L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberOS15753
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: