MEDICARE: CARITAS OBSTETRICS AND GYNECOLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME85066	FL

General Provider Information

NPI Number	:	1033316799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARITAS OBSTETRICS AND GYNECOLOGY

Provider Business Mailing Address
First Line	:	8340 COLLIER BLVD STE 406
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-3626
Country	:	US
Telephone Number	:	239-774-1355
Fax Number	:

Provider Business Practice Location Address
First Line	:	8340 COLLIER BLVD STE 406
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-3626
Country	:	US
Telephone Number	:	239-774-1355
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ANGELA DIANE FLIPPIN-TRAINER
Credential	:	M.D.
Telephone Number	:	239-774-1355

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	07/02/2008

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