Provider Demographics
NPI:1841744257
Name:MAGGIO, ANIELA
Entity type:Individual
Prefix:
First Name:ANIELA
Middle Name:
Last Name:MAGGIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 GOODLETTE RD
Mailing Address - Street 2:STE 204
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5618
Mailing Address - Country:US
Mailing Address - Phone:239-777-9321
Mailing Address - Fax:
Practice Address - Street 1:3700 WASHINGTON ST
Practice Address - Street 2:SUITE 400
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8256
Practice Address - Country:US
Practice Address - Phone:954-980-0361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9204147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily