Provider Demographics
NPI:1588329171
Name:NAPLES PRIMARY CARE LLC
Entity type:Organization
Organization Name:NAPLES PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:NAPLES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:330-306-8106
Mailing Address - Street 1:8480 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2343
Mailing Address - Country:US
Mailing Address - Phone:330-306-8106
Mailing Address - Fax:330-637-0048
Practice Address - Street 1:8480 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2343
Practice Address - Country:US
Practice Address - Phone:330-306-8106
Practice Address - Fax:330-637-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2835829Medicaid