Provider Demographics
NPI:1376743617
Name:ALESSI FAMILY CARE PA
Entity Type:Organization
Organization Name:ALESSI FAMILY CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:ALESSI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-992-5444
Mailing Address - Street 1:9400 BONITA BEACH RD SE STE 102
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4520
Mailing Address - Country:US
Mailing Address - Phone:239-992-5444
Mailing Address - Fax:239-992-1315
Practice Address - Street 1:9400 BONITA BEACH RD SE STE 102
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4520
Practice Address - Country:US
Practice Address - Phone:239-992-5444
Practice Address - Fax:239-992-1315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1878OtherMEDICARE PROVIDER NUMBER
FL45155OtherBCBS OF FLORIDA PROVIDER