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General NPI Number Information
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NPI Number | 1215547310
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Entity Type | Organization
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Legal Business Name | PRIME MD OF NAPLES
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 2515 NORTHBROOKE PLAZA DR STE 200
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City | NAPLES
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State | FL
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Zip | 34119-8088
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Country | US
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Telephone | 949-302-5644
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Fax |
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Provider Business Mailing Address
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Address Line | 2515 NORTHBROOKE PLAZA DR STE 200
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City | NAPLES
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State | FL
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Zip | 34119-8088
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Country | US
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Telephone | 239-325-6955
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Fax | 239-396-7155
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. COSMINA ILEANA POPA
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Credential | MD
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Telephone | 239-325-6955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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