Provider Demographics
NPI:1124807375
Name:ALLEGIANCE HEALTH OF SOUTHWEST FLORIDA LLC
Entity type:Organization
Organization Name:ALLEGIANCE HEALTH OF SOUTHWEST FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-302-4723
Mailing Address - Street 1:16206 CAMDEN LAKES CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-2881
Mailing Address - Country:US
Mailing Address - Phone:305-302-4723
Mailing Address - Fax:
Practice Address - Street 1:6750 IMMOKALEE RD UNIT 203
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-9083
Practice Address - Country:US
Practice Address - Phone:239-359-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty