MEDICARE: NAPLES VASCULAR SPECIALISTS 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	2086S0129X	Vascular Surgery Physician

General Provider Information

NPI Number	:	1659710556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAPLES VASCULAR SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	130 9TH ST N STE 120
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-6231
Country	:	US
Telephone Number	:	239-649-0550
Fax Number	:	239-649-1785

Provider Business Practice Location Address
First Line	:	130 9TH ST N STE 120
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-6231
Country	:	US
Telephone Number	:	239-649-0550
Fax Number	:	239-649-1785

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES MICHAEL SCANLON
Credential	:	M.D.
Telephone Number	:	239-649-0550

Provider Enumeration Date	:	06/24/2013
Last Update Date	:	11/15/2013

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