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865 - 867 91st Avenue N Naples FL 34108-2426 | |
| (239) 434-6596 | |
| (239) 434-6590 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 865 - 867 91st Avenue N, Naples, Florida |
| Authorized Official Name and Position | Valerie A. Stec (C.E.O.) |
| Authorized Official Contact | 2394346596 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3341 Tamiami Trl N Naples FL 34103-4165 Ph: (239) 434-6596 | 865 - 867 91st Avenue N Naples FL 34108-2426 Ph: (239) 434-6596 |
| NPI Number | 1053516823 |
|---|---|
| Provider Enumeration Date | 06/20/2007 |
| Last Update Date | 04/12/2023 |
| Certification Date | 04/06/2023 |
| Medicare PECOS PAC ID | 8123113750 |
|---|---|
| Medicare Enrollment ID | O20070927000559 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053516823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0811AD6189-00 (Florida) | Primary |
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