Healthcare Provider Details

I. General information

NPI: 1235049834
Provider Name (Legal Business Name): ANNA LIZ ACEVEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 9TH ST N STE 101
NAPLES FL
34102-5886
US

IV. Provider business mailing address

423 PAULINE AVE
LEHIGH ACRES FL
33974-4404
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-5820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN11050816
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: