Healthcare Provider Details

I. General information

NPI: 1225429889
Provider Name (Legal Business Name): MARIA FRANCESCA ZAMPOGNA WILSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 09/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 DAVIS BLVD STE 203
NAPLES FL
34104-5321
US

IV. Provider business mailing address

6400 DAVIS BLVD STE 103
NAPLES FL
34104-5321
US

V. Phone/Fax

Practice location:
  • Phone: 239-775-2300
  • Fax:
Mailing address:
  • Phone: 239-775-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 9108480
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: