1043204431 NPI number — PAMELA PAPOLA MD PA

Table of content: MRS. MARTHA LEE ASARISI RPH (NPI 1003947375)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043204431 NPI number — PAMELA PAPOLA MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAMELA PAPOLA MD PA
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:
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:
1043204431
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/22/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 511896
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PUNTA GORDA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33951-1896
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-255-3722
Provider Business Mailing Address Fax Number:
941-255-3723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3410 TAMIAMI TRL
Provider Second Line Business Practice Location Address:
1
Provider Business Practice Location Address City Name:
PORT CHARLOTTE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33952-8127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-255-3722
Provider Business Practice Location Address Fax Number:
941-255-3723
Provider Enumeration Date:
08/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PAPOLA
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
941-255-3722

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  ME63518 , 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)

  • Identifier: 71336 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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