Provider Demographics
NPI:1316237696
Name:NAPLES FAMILY HEALTH & WELLNESS INC
Entity type:Organization
Organization Name:NAPLES FAMILY HEALTH & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MCC
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:MCC
Authorized Official - Phone:954-563-4472
Mailing Address - Street 1:970 5TH AVE N
Mailing Address - Street 2:970 5TH AVE NORTH
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5817
Mailing Address - Country:US
Mailing Address - Phone:239-692-8160
Mailing Address - Fax:239-331-4148
Practice Address - Street 1:970 5TH AVE N
Practice Address - Street 2:970 5TH AVE NORTH
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5817
Practice Address - Country:US
Practice Address - Phone:239-692-8160
Practice Address - Fax:239-331-4148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEX935AMedicare PIN