Renewal Geriatric Primary Care Pa | |
4915 Rattlesnake Hammock Rd Ste 156 Naples FL 34113-6959 | |
(239) 206-0115 | |
(239) 307-2455 |
Full Name | Renewal Geriatric Primary Care Pa |
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Speciality | Internal Medicine |
Location | 4915 Rattlesnake Hammock Rd Ste 156, Naples, Florida |
Authorized Official Name and Position | Nana Mimura (OWNER) |
Authorized Official Contact | 2392060115 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Renewal Geriatric Primary Care Pa 4915 Rattlesnake Hammock Rd Ste 156 Naples FL 34113-6959 Ph: (239) 206-0115 | Renewal Geriatric Primary Care Pa 4915 Rattlesnake Hammock Rd Ste 156 Naples FL 34113-6959 Ph: (239) 206-0115 |
NPI Number | 1831661222 |
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Provider Enumeration Date | 12/22/2018 |
Last Update Date | 08/16/2022 |
Medicare PECOS PAC ID | 9234470808 |
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Medicare Enrollment ID | O20190408002828 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831661222 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Nana Mimura |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1568563625 PECOS PAC ID: 9537175658 Enrollment ID: I20141114001212 |
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