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General NPI Number Information
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NPI Number | 1144339383
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Entity Type | Individual
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Provider Name | MATTHEW JAMES PALICKA ARNP
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 399 9TH ST N SUITE 300
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City | NAPLES
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State | FL
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Zip | 34102-5820
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Country | US
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Telephone | 239-436-5634
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Fax | 239-649-1290
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Provider Business Mailing Address
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Address Line | 6101 PINE RIDGE RD DESK 12/13
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City | NAPLES
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State | FL
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Zip | 34119-3900
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Country | US
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Telephone | 239-263-0849
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Fax | 239-263-2376
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP3209042
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5018574
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License Number State | NC
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