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General NPI Number Information
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NPI Number | 1669764585
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Entity Type | Organization
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Legal Business Name | PHYSICIAN LED ACCESS NETWORK (PLAN) OF COLLIER COUNTY
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 05/11/2011
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Provider Practice Location Address
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Address Line | 1012 GOODLETTE RD N STE 201
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City | NAPLES
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State | FL
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Zip | 34102-5463
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Country | US
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Telephone | 239-776-3016
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Fax | 239-435-1297
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Provider Business Mailing Address
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Address Line | 1012 GOODLETTE RD N STE 201
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City | NAPLES
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State | FL
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Zip | 34102-5463
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Country | US
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Telephone | 239-776-3016
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Fax | 239-435-1297
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | MRS. MICHELLE S JAY
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Credential |
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Telephone | 239-776-3016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State | FL
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