Provider Demographics
NPI:1134409535
Name:NAPLES PERITONEAL DIALYSIS CENTER,LLC
Entity type:Organization
Organization Name:NAPLES PERITONEAL DIALYSIS CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICEVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-596-3044
Mailing Address - Street 1:878 109TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-1821
Mailing Address - Country:US
Mailing Address - Phone:239-596-3044
Mailing Address - Fax:239-596-1395
Practice Address - Street 1:878 109TH AVE N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1821
Practice Address - Country:US
Practice Address - Phone:239-596-3044
Practice Address - Fax:239-596-1395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty