MEDICARE: NAPLES PHYSICIANS HOSPITAL ORGANIZATION INC.

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	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1215346523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAPLES PHYSICIANS HOSPITAL ORGANIZATION INC.

Provider Business Mailing Address
First Line	:	851 5TH AVE N STE 201
Second Line	:	SUITE 201
City	:	NAPLES
State	:	FL
Zip	:	34102-5582
Country	:	US
Telephone Number	:	217-714-5364
Fax Number	:

Provider Business Practice Location Address
First Line	:	851 5TH AVE N STE 201
Second Line	:	SUITE 201
City	:	NAPLES
State	:	FL
Zip	:	34102-5582
Country	:	US
Telephone Number	:	217-714-5364
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MS. SUSAN JARDONE
Credential	:	RN, BS, CRRN, CCM
Telephone Number	:	239-659-7701

Provider Enumeration Date	:	08/12/2014
Last Update Date	:	08/12/2014

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