Provider Demographics
NPI:1457675316
Name:QUARLES, ADAM JAMES (ARNP)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:JAMES
Last Name:QUARLES
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:7335 GLADIOLUS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-5101
Practice Address - Country:US
Practice Address - Phone:239-985-1925
Practice Address - Fax:239-321-6044
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9354314363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0FT3OtherBCBS OF FL
FL008549800Medicaid
FL5722838OtherAETNA
FLP953861OtherOPTIMUM
FL6916075OtherCIGNA
FLP01318563OtherRR MEDICARE
FLP1014958OtherFREEDOM
FL008549800Medicaid
FLHF162ZMedicare PIN