MEDICARE: NCH NAPLES OUTPATIENT SURGICAL INSTITUTE 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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1558189738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NCH NAPLES OUTPATIENT SURGICAL INSTITUTE LLC

Provider Business Mailing Address
First Line	:	311 9TH ST N STE 206
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-5887
Country	:	US
Telephone Number	:	239-228-8884
Fax Number	:	239-734-9916

Provider Business Practice Location Address
First Line	:	311 9TH ST N STE 206
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-5887
Country	:	US
Telephone Number	:	239-228-8884
Fax Number	:	239-734-9916

Authorized Official
Title or Position	:	OFFICER AND AUTHORIZED OFFICIAL
Name	:	JENNIFER BOYD BALDOCK
Credential	:
Telephone Number	:	615-234-5954

Provider Enumeration Date	:	09/27/2024
Last Update Date	:	12/02/2025

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