Healthcare Provider Details

I. General information

NPI: 1427247014
Provider Name (Legal Business Name): MARIA T VARGAS MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 8TH ST S STE 303
NAPLES FL
34102-6117
US

IV. Provider business mailing address

201 8TH ST S STE 303
NAPLES FL
34102-6117
US

V. Phone/Fax

Practice location:
  • Phone: 239-434-2882
  • Fax: 239-434-7639
Mailing address:
  • Phone: 239-434-2882
  • Fax: 239-434-7639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME79687
License Number StateFL

VIII. Authorized Official

Name: MARIA T VARGAS
Title or Position: OWNER
Credential: MD
Phone: 239-434-2882