Healthcare Provider Details

I. General information

NPI: 1376928176
Provider Name (Legal Business Name): JUDITH ELIBRI ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 02/08/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 GOODLETTE-FRANK RD N #101
NAPLES FL
34103-4595
US

IV. Provider business mailing address

2450 GOODLETTE-FRANK RD N #101
NAPLES FL
34103-4595
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-8460
  • Fax: 239-643-1489
Mailing address:
  • Phone: 239-624-8460
  • Fax: 239-643-1489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9303192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: