Provider Demographics
NPI:1144682618
Name:FIRST ASSISTANT OF NAPLES
Entity type:Organization
Organization Name:FIRST ASSISTANT OF NAPLES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:SEVILLA
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:239-596-7873
Mailing Address - Street 1:7551 SAN MIGUEL WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-7165
Mailing Address - Country:US
Mailing Address - Phone:239-596-7873
Mailing Address - Fax:239-591-8981
Practice Address - Street 1:7551 SAN MIGUEL WAY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-7165
Practice Address - Country:US
Practice Address - Phone:239-596-7873
Practice Address - Fax:239-591-8981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3023792163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL311819300Medicaid