Provider Demographics
NPI:1548153588
Name:POLI ASSUNCAO, PERI NICOLE
Entity type:Individual
Prefix:MRS
First Name:PERI
Middle Name:NICOLE
Last Name:POLI ASSUNCAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12831 CYPRESS CAPE CIR UNIT 351
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1612
Mailing Address - Country:US
Mailing Address - Phone:239-989-6088
Mailing Address - Fax:
Practice Address - Street 1:12831 CYPRESS CAPE CIR UNIT 351
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1612
Practice Address - Country:US
Practice Address - Phone:239-989-6088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9648481163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse