Healthcare Provider Details

I. General information

NPI: 1831597525
Provider Name (Legal Business Name): UNITED SPECIALISTS OUTREACH NETWORK, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2014
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 IMMOKALEE RD SUITE 201
NAPLES FL
34110-1421
US

IV. Provider business mailing address

1860 SENEGAL DATE DR
NAPLES FL
34119-3386
US

V. Phone/Fax

Practice location:
  • Phone: 718-382-7909
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAULA VISHNEVSKIY
Title or Position: BILLING DEPARTMENT MANAGER
Credential:
Phone: 718-382-7909