=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376651091
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOMAN TO WOMAN GYN OF NAPLES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2006
-----------------------------------------------------
Last Update Date | 01/16/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1201 PIPER BLVD STE 21
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34110-1385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-591-3311
-----------------------------------------------------
Fax | 239-591-3327
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1201 PIPER BLVD STE 21
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34110-1385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-591-3311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | JANICE NICOLE YOUNG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 239-591-3311
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VF0040X
-----------------------------------------------------
Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
-----------------------------------------------------
License Number | ME62510
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207VG0400X
-----------------------------------------------------
Taxonomy Name | Gynecology Physician
-----------------------------------------------------
License Number | ME62510
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------