Provider Demographics
NPI:1578708319
Name:FLORENCE FACTOR PA
Entity Type:Organization
Organization Name:FLORENCE FACTOR PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FACTOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:239-370-3918
Mailing Address - Street 1:5051 CASTELLO DRIVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-8902
Mailing Address - Country:US
Mailing Address - Phone:239-370-3918
Mailing Address - Fax:239-649-5051
Practice Address - Street 1:5051 CASTELLO DRIVE
Practice Address - Street 2:SUITE 230
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-8902
Practice Address - Country:US
Practice Address - Phone:239-370-3918
Practice Address - Fax:239-649-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW6461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z3242AMedicare PIN