1710072640 NPI number — LOUIS F. FOLEY, M.D., P.A.

Table of content: (NPI 1417968116)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710072640 NPI number — LOUIS F. FOLEY, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOUIS F. FOLEY, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1710072640
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2338 IMMOKALEE RD
Provider Second Line Business Mailing Address:
PMB 152
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34110-1445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-566-7272
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1217 PIPER BLVD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34110-1433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-566-7272
Provider Business Practice Location Address Fax Number:
239-566-2088
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FOLEY
Authorized Official First Name:
LOUIS
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
239-566-7272

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  79601 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: 90426 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 269687800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 37924 . This is a "BCBS INDIVIDUAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 01023 . This is a "BCBS INDIVIDUAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 271588100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 98516 . This is a "BCBS GROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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