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General NPI Number Information
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NPI Number | 1811620362
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Entity Type | Organization
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Legal Business Name | KING'S MEDICAL LLC
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 6945 CARLISLE CT
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City | NAPLES
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State | FL
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Zip | 34109-6883
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Country | US
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Telephone | 908-577-8380
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Fax |
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Provider Business Mailing Address
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Address Line | 2610 MARSHCREEK LN APT 102
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City | NAPLES
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State | FL
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Zip | 34119-7949
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/COO
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Name | NICOLAS D'ALTO
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Credential |
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Telephone | 908-577-8380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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