Healthcare Provider Details

I. General information

NPI: 1013432251
Provider Name (Legal Business Name): ALICIA A SLOAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6376 PINE RIDGE RD STE 300
NAPLES FL
34119-3908
US

IV. Provider business mailing address

6101 PINE RIDGE ROAD ATTN: CLINIC BUSINESS OFFICE
NAPLES FL
34119-3900
US

V. Phone/Fax

Practice location:
  • Phone: 239-348-4221
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1292
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: