Provider Demographics
NPI:1881656858
Name:PAOLA, FREDERICK A (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:A
Last Name:PAOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8523
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-8523
Mailing Address - Country:US
Mailing Address - Phone:239-643-1462
Mailing Address - Fax:239-643-3514
Practice Address - Street 1:850 CENTRAL AVE
Practice Address - Street 2:STE 302
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102
Practice Address - Country:US
Practice Address - Phone:239-643-1462
Practice Address - Fax:239-643-3514
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68408207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27651OtherBCBS
FL27651WMedicare ID - Type Unspecified
F20101Medicare UPIN