1316203474 NPI number — MR. WILLIAM EDWARD LENTULAY M.ED.

Table of content: MR. WILLIAM EDWARD LENTULAY M.ED. (NPI 1316203474)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316203474 NPI number — MR. WILLIAM EDWARD LENTULAY M.ED.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LENTULAY
Provider First Name:
WILLIAM
Provider Middle Name:
EDWARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.ED.
Provider Gender Code:
M

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:
1316203474
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2675 HORSESHOE DR S
Provider Second Line Business Mailing Address:
SUITE 402
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34104-6155
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-331-8400
Provider Business Mailing Address Fax Number:
239-777-3097

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2675 HORSESHOE DR S
Provider Second Line Business Practice Location Address:
SUITE 402
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34104-6155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-331-8400
Provider Business Practice Location Address Fax Number:
239-777-3097
Provider Enumeration Date:
04/03/2012

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: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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