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NPI Code Detail

MEDICARE: FAMILY CENTERED PRIMARY CARE LLC

MEDICARE: FAMILY CENTERED PRIMARY CARE LLC
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
1363LF0000XFamily Nurse PractitionerARNP9220215FL

General Provider Information

NPI Number : 1518467935
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY CENTERED PRIMARY CARE LLC
Provider Business Mailing Address
First Line : 4760 TAMIAMI TRL N STE 24
Second Line :
City : NAPLES
State : FL
Zip : 34103-3065
Country : US
Telephone Number : 239-220-8875
Fax Number :
Provider Business Practice Location Address
First Line : 4760 TAMIAMI TRL N STE 24
Second Line :
City : NAPLES
State : FL
Zip : 34103-3065
Country : US
Telephone Number : 239-220-8875
Fax Number :
Authorized Official
Title or Position : OWNER
Name : TERI L NIES
Credential : ARNP
Telephone Number : 239-220-8875
Provider Enumeration Date : 02/13/2018
Last Update Date : 02/23/2018

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Directions to “FAMILY CENTERED PRIMARY CARE LLC ” Practice Location

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