Healthcare Provider Details

I. General information

NPI: 1659406221
Provider Name (Legal Business Name): NAPLES SOUTH-EAST ASSISTANCE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 INDUSTRIAL BLVD SUITE 152
NAPLES FL
34104-3739
US

IV. Provider business mailing address

222 INDUSTRIAL BLVD SUITE 152
NAPLES FL
34104-3739
US

V. Phone/Fax

Practice location:
  • Phone: 239-262-4765
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CARLOS M GONZALEZ
Title or Position: PRESIDENT
Credential:
Phone: 239-262-4765