Provider Demographics
NPI:1740583624
Name:NAPLES HEALTH CARE, INC
Entity Type:Organization
Organization Name:NAPLES HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:R
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-304-9290
Mailing Address - Street 1:4947 TAMIAMI TRL N
Mailing Address - Street 2:STE 206
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3026
Mailing Address - Country:US
Mailing Address - Phone:239-304-9290
Mailing Address - Fax:
Practice Address - Street 1:4947 TAMIAMI TRL N
Practice Address - Street 2:STE 206
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3026
Practice Address - Country:US
Practice Address - Phone:239-304-9290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90692261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268370900Medicaid
FLAG049Medicare UPIN