1922153386 NPI number — REBECCA ALBERTI DE PUELL D.N.P., F.N.P.-BC

Table of content: REBECCA ALBERTI DE PUELL D.N.P., F.N.P.-BC (NPI 1922153386)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922153386 NPI number — REBECCA ALBERTI DE PUELL D.N.P., F.N.P.-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBERTI DE PUELL
Provider First Name:
REBECCA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.N.P., F.N.P.-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922153386
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1104 CEDAR CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARCO ISLAND
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34145-2505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-389-9900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
247 N COLLIER BLVD STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARCO ISLAND
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34145-3015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-389-9900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  ARNP9330314 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 004145500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".