Healthcare Provider Details

I. General information

NPI: 1679272215
Provider Name (Legal Business Name): APEX BRAIN & SPINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2023
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 KRAFT RD STE 203
NAPLES FL
34105-5020
US

IV. Provider business mailing address

2338 IMMOKALEE RD STE 203
NAPLES FL
34110-1445
US

V. Phone/Fax

Practice location:
  • Phone: 239-919-4342
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGORY CANNARSA
Title or Position: OWNER
Credential: MD
Phone: 484-574-4757