Provider Demographics
NPI:1245211077
Name:NAPLES WOMENS CENTER, LLC
Entity Type:Organization
Organization Name:NAPLES WOMENS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:DENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-513-1992
Mailing Address - Street 1:1726 MEDICAL BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1426
Mailing Address - Country:US
Mailing Address - Phone:239-513-1992
Mailing Address - Fax:239-513-9022
Practice Address - Street 1:10201 ARCOS AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-9459
Practice Address - Country:US
Practice Address - Phone:239-495-5896
Practice Address - Fax:239-495-5916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265399100Medicaid