MEDICARE: BARBARA CASIMIR RN/ ADMINISTRATOR

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	163WA2000X	Administrator Registered Nurse	RN9422161	FL
2	163WH0200X	Home Health Registered Nurse	30212294	FL
3	163WA2000X	Administrator Registered Nurse	30212294	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164139432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA CASIMIR RN/ ADMINISTRATOR

Provider Business Mailing Address
First Line	:	2977 GOODLETTE-FRANK RD N STE 1
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-4613
Country	:	US
Telephone Number	:	239-331-3548
Fax Number	:	239-842-6182

Provider Business Practice Location Address
First Line	:	2977 GOODLETTE-FRANK RD N STE 1
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-4613
Country	:	US
Telephone Number	:	239-331-3548
Fax Number	:	239-842-6182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2022
Last Update Date	:	11/09/2022

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