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General NPI Number Information
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NPI Number | 1295060705
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Entity Type | Organization
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Legal Business Name | JUNIPER MICHAEL
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Dates
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Enumeration Date | 10/16/2009
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Last Update Date | 10/16/2009
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Provider Practice Location Address
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Address Line | 1155 ENCORE WAY
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City | NAPLES
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State | FL
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Zip | 34110-9172
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Country | US
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Telephone | 239-598-1368
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Fax | 239-593-8603
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Provider Business Mailing Address
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Address Line | 1155 ENCORE WAY
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City | NAPLES
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State | FL
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Zip | 34110-9172
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Country | US
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Telephone | 239-598-1368
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Fax | 239-593-8603
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. ERIN SAKMAR
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Credential |
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Telephone | 239-598-1368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | AL9761
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License Number State | FL
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