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NPI Code Detail

MEDICARE: KING'S MEDICAL LLC

MEDICARE: KING'S MEDICAL 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
1207R00000XInternal Medicine Physician
2261Q00000XClinic/Center
3261QP2300XPrimary Care Clinic/Center
4261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1811620362
Entity Type Code : Organization
Provider Name (Legal Business Name) : KING'S MEDICAL LLC
Provider Business Mailing Address
First Line : 2610 MARSHCREEK LN APT 102
Second Line :
City : NAPLES
State : FL
Zip : 34119-7949
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6945 CARLISLE CT
Second Line :
City : NAPLES
State : FL
Zip : 34109-6883
Country : US
Telephone Number : 908-577-8380
Fax Number :
Authorized Official
Title or Position : CEO/COO
Name : NICOLAS D'ALTO
Credential :
Telephone Number : 908-577-8380
Provider Enumeration Date : 07/01/2022
Last Update Date : 07/01/2022

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Directions to “KING'S MEDICAL LLC ” Practice Location

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