Provider Demographics
NPI:1285613927
Name:FOLEY, JENNIFER MCLEAN (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MCLEAN
Last Name:FOLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 IMMOKALEE RD
Mailing Address - Street 2:SUITE 152
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1445
Mailing Address - Country:US
Mailing Address - Phone:239-566-7272
Mailing Address - Fax:239-566-2088
Practice Address - Street 1:11181 HEALTH PARK BLVD
Practice Address - Street 2:SUITE 2277
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-5738
Practice Address - Country:US
Practice Address - Phone:239-566-7272
Practice Address - Fax:239-566-2088
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90426208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01023OtherBCBS INDIVIDUAL
FL98516OtherBCBS GROUP
I51454Medicare UPIN