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General NPI Number Information
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NPI Number | 1699092189
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Entity Type | Individual
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Provider Name | LORETTA FAUSTINO
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Gender | Female
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 1032 PORT ORANGE CT
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City | NAPLES
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State | FL
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Zip | 34120-2914
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Country | US
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Telephone | 239-455-0900
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Fax | 866-495-7055
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Provider Business Mailing Address
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Address Line | 3811 AIRPORT PULLING RD N
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City | NAPLES
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State | FL
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Zip | 34105-2512
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Country | US
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Telephone | 239-455-0900
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Fax | 866-495-7055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | CL01082297
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License Number State | FL
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