Healthcare Provider Details

I. General information

NPI: 1073971206
Provider Name (Legal Business Name): VIRTUAL HEALTH VENTURES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2016
Last Update Date: 02/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7955 AIRPORT PULLING RD N SUITE 205
NAPLES FL
34109-1794
US

IV. Provider business mailing address

6017 PINE RIDGE RD # 274
NAPLES FL
34119-3956
US

V. Phone/Fax

Practice location:
  • Phone: 239-322-0066
  • Fax:
Mailing address:
  • Phone: 239-322-0066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberME112097
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberME112097
License Number StateFL

VIII. Authorized Official

Name: DR. TIMOTHY MATTHEW EVERETT SR.
Title or Position: DIRECTOR
Credential: M.D.
Phone: 239-322-0066