MEDICARE: NAPLES DIRECT MEDICAL PLLC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1710562764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAPLES DIRECT MEDICAL PLLC

Provider Business Mailing Address
First Line	:	1755 HERITAGE TRL STE 601
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34112-7600
Country	:	US
Telephone Number	:	239-529-2581
Fax Number	:	239-331-8287

Provider Business Practice Location Address
First Line	:	1755 HERITAGE TRL STE 601
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34112-7600
Country	:	US
Telephone Number	:	239-529-2581
Fax Number	:	239-331-8287

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARY ANNE C FARRIS
Credential	:	MD
Telephone Number	:	330-978-8754

Provider Enumeration Date	:	03/11/2021
Last Update Date	:	06/15/2021

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Directions to “NAPLES DIRECT MEDICAL PLLC ” Practice Location

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