Healthcare Provider Details

I. General information

NPI: 1114417508
Provider Name (Legal Business Name): VASCULAR CENTER OF NAPLES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2018
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 VETERANS PARK DR STE 2203
NAPLES FL
34109-0596
US

IV. Provider business mailing address

1875 VETERANS PARK DR STE 2203
NAPLES FL
34109-0596
US

V. Phone/Fax

Practice location:
  • Phone: 239-431-5884
  • Fax: 239-631-6907
Mailing address:
  • Phone: 239-431-5884
  • Fax: 239-631-6907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: AMY NILOFF
Title or Position: SUPERVISOR
Credential:
Phone: 239-431-5884