Healthcare Provider Details

I. General information

NPI: 1659710556
Provider Name (Legal Business Name): NAPLES VASCULAR SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 11/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 9TH ST N STE 120
NAPLES FL
34102-6231
US

IV. Provider business mailing address

130 9TH ST N STE 120
NAPLES FL
34102-6231
US

V. Phone/Fax

Practice location:
  • Phone: 239-649-0550
  • Fax: 239-649-1785
Mailing address:
  • Phone: 239-649-0550
  • Fax: 239-649-1785

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: DR. JAMES MICHAEL SCANLON
Title or Position: OWNER
Credential: M.D.
Phone: 239-649-0550