Healthcare Provider Details

I. General information

NPI: 1740234608
Provider Name (Legal Business Name): ANTHONY VERNAVA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 PINE RIDGE RD
NAPLES FL
34119-3900
US

IV. Provider business mailing address

6101 PINE RIDGE RD
NAPLES FL
34119-3900
US

V. Phone/Fax

Practice location:
  • Phone: 239-348-4531
  • Fax: 239-348-4149
Mailing address:
  • Phone: 239-348-4531
  • Fax: 239-348-4149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberFLME0077508
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: