Provider Demographics
NPI:1487193892
Name:INFECTIOUS DISEASE ASSOCIATES OF NAPLES LLC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE ASSOCIATES OF NAPLES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-624-0800
Mailing Address - Street 1:3021 AIRPORT RD N STE 103
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-3077
Mailing Address - Country:US
Mailing Address - Phone:941-277-9110
Mailing Address - Fax:833-464-1853
Practice Address - Street 1:3021 AIRPORT RD N STE 103
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-3077
Practice Address - Country:US
Practice Address - Phone:941-277-9110
Practice Address - Fax:833-464-1853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty