PSG of Naples LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

OS007183 Issued in FL

Legal business name

PSG OF NAPLES LLC

Practice address

40 SE 5TH St Ste 406
Boca Raton, FL 33432-6003

Phone

(561) 368-7118

Fax

(561) 368-7116

NPI assigned

Jun 15, 2010

Last updated

Jun 15, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carolyn Via

Title

MGRM

Phone

(561) 368-7118

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1619298544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SE 5TH ST STE 406",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334326003",
            "telephone_number": "561-368-7118",
            "fax_number": "561-368-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SE 5TH ST STE 406",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334326003",
            "telephone_number": "561-368-7118",
            "fax_number": "561-368-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSG OF NAPLES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "VIA",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "MGRM",
        "authorized_official_telephone_number": "561-368-7118"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "OS007183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.