1952517880 NPI number — DR. GENOVA ANN STEARNS DO

Table of content: DR. GENOVA ANN STEARNS DO (NPI 1952517880)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952517880 NPI number — DR. GENOVA ANN STEARNS DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEARNS
Provider First Name:
GENOVA
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
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:
1952517880
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7920 LEICESTER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34104-7444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-354-0971
Provider Business Mailing Address Fax Number:
239-354-0971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1048 GOODLETTE RD N
Provider Second Line Business Practice Location Address:
STE. 101
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34102-5491
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-430-9444
Provider Business Practice Location Address Fax Number:
239-430-9432
Provider Enumeration Date:
05/15/2007

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: 2084P0804X , with the licence number:  OS6828 , 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)





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