Provider Demographics
NPI:1285616219
Name:NORTH NAPLES FAMILY CARE INC
Entity type:Organization
Organization Name:NORTH NAPLES FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BOZZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-596-7731
Mailing Address - Street 1:5490 BRYSON DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0921
Mailing Address - Country:US
Mailing Address - Phone:239-596-7731
Mailing Address - Fax:239-596-2285
Practice Address - Street 1:5490 BRYSON DR
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0921
Practice Address - Country:US
Practice Address - Phone:239-596-7731
Practice Address - Fax:239-596-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51559OtherBLUE CROSS OF FLORIDA
FL51559OtherBLUE CROSS OF FLORIDA