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General NPI Number Information
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NPI Number | 1972628782
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Entity Type | Organization
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Legal Business Name | NORTH NAPLES DIALYSIS LLC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 1750 SW HEALTH PKWY
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City | NAPLES
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State | FL
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Zip | 34109-0420
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Country | US
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Telephone | 239-594-8758
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Fax | 239-594-8762
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Provider Business Mailing Address
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Address Line | 1750 SW HEALTH PKWY
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City | NAPLES
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State | FL
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Zip | 34109-0420
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Country | US
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Telephone | 239-594-8758
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Fax | 239-594-8762
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Authorized Official
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Title or Position | CFO
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Name | LAUREEN MARINO
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Credential | MBA
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Telephone | 239-594-8758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | PENDFING
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License Number State | FL
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