Provider Demographics
NPI:1992949051
Name:MARY J. FOLEY, D.O., P.A.
Entity type:Organization
Organization Name:MARY J. FOLEY, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN CEO/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-354-4413
Mailing Address - Street 1:PO BOX 111482
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-0125
Mailing Address - Country:US
Mailing Address - Phone:239-354-4413
Mailing Address - Fax:239-791-1079
Practice Address - Street 1:1855 VETERANS PARK DR
Practice Address - Street 2:SUITE 103
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0446
Practice Address - Country:US
Practice Address - Phone:239-354-4413
Practice Address - Fax:239-791-1079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7354261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57610OtherBCBS
FL57610XMedicare Oscar/Certification
FL57610OtherBCBS