Provider Demographics
NPI:1669859674
Name:VAVA PARTNERS LLC
Entity Type:Organization
Organization Name:VAVA PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VAVA
Authorized Official - Middle Name:YAO
Authorized Official - Last Name:NYANUDOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-293-3601
Mailing Address - Street 1:8855 IMMOKALEE RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-3914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8855 IMMOKALEE RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-3914
Practice Address - Country:US
Practice Address - Phone:239-293-3601
Practice Address - Fax:239-775-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care