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General NPI Number Information
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NPI Number | 1922400340
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Entity Type | Organization
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Legal Business Name | NORTH NAPLES PEDIATRIC CENTER
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 9160 GALLERIA COURT
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City | NAPLES
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State | FL
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Zip | 34109
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Country | US
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Telephone | 239-514-8787
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Fax | 239-514-1965
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Provider Business Mailing Address
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Address Line | 9160 GALLERIA COURT
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City | NAPLES
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State | FL
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Zip | 34109
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Country | US
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Telephone | 239-514-8787
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Fax | 239-514-1965
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Authorized Official
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Title or Position | PHYSICAN
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Name | DR. DINA A BADRA
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Credential | M.D.
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Telephone | 239-514-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME0065421
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License Number State | FL
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