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General NPI Number Information
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NPI Number | 1508248766
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Entity Type | Organization
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Legal Business Name | SK MEDICAL SERVICES OF SOUTH FLORIDA LLC
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 15570 MARCELLO CIR
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City | NAPLES
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State | FL
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Zip | 34110-2839
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Country | US
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Telephone | 414-803-4352
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Fax |
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Provider Business Mailing Address
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Address Line | 15570 MARCELLO CIR
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City | NAPLES
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State | FL
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Zip | 34110-2839
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Country | US
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Telephone | 414-803-4352
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Fax |
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Authorized Official
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Title or Position | SOLE MBR
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Name | MS. SHAWN KING
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Credential |
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Telephone | 414-803-4352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9322553
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License Number State | FL
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