Healthcare Provider Details

I. General information

NPI: 1902593809
Provider Name (Legal Business Name): PINNACLE HEALTH SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 GOODLETTE RD STE 130
NAPLES FL
34102-5402
US

IV. Provider business mailing address

800 GOODLETTE RD STE 130
NAPLES FL
34102-5402
US

V. Phone/Fax

Practice location:
  • Phone: 239-649-3333
  • Fax: 239-649-3386
Mailing address:
  • Phone: 239-649-3333
  • Fax: 239-649-3386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TYRONE MEDINA JR.
Title or Position: MD
Credential: MD
Phone: 239-649-3333