Provider Demographics
NPI:1225036213
Name:NAPLES PEDIATRICS INC.
Entity Type:Organization
Organization Name:NAPLES PEDIATRICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:IRRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-593-7000
Mailing Address - Street 1:5400 PARK CENTRAL CT
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-6001
Mailing Address - Country:US
Mailing Address - Phone:239-593-7000
Mailing Address - Fax:239-593-7008
Practice Address - Street 1:5400 PARK CENTRAL CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-5923
Practice Address - Country:US
Practice Address - Phone:239-593-7000
Practice Address - Fax:239-593-7008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0065935208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254365600Medicaid
FL34401OtherBLUE CROSS GRP ID