Healthcare Provider Details

I. General information

NPI: 1770920191
Provider Name (Legal Business Name): ANIECE THERMIDOR ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2013
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4490 20TH ST NE
NAPLES FL
34120-0479
US

IV. Provider business mailing address

4490 20TH ST NE
NAPLES FL
34120-0479
US

V. Phone/Fax

Practice location:
  • Phone: 239-209-7894
  • Fax:
Mailing address:
  • Phone: 239-209-7894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9259996
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN9259996
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9259996
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: