MEDICARE: DR. MARIA GENE NOLL DPM

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	213E00000X	Podiatrist	PO2067	FL

General Provider Information

NPI Number	:	1801807490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA GENE NOLL DPM

Provider Business Mailing Address
First Line	:	10621 AIRPORT PULLING RD N
Second Line	:	STE 4
City	:	NAPLES
State	:	FL
Zip	:	34109-7333
Country	:	US
Telephone Number	:	239-592-0700
Fax Number	:	239-592-0700

Provider Business Practice Location Address
First Line	:	10621 AIRPORT PULLING RD N
Second Line	:	SUITE 4
City	:	NAPLES
State	:	FL
Zip	:	34109-7333
Country	:	US
Telephone Number	:	239-592-0700
Fax Number	:	239-592-0700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	11/07/2007

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