# NAPLES GYNECOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073889028
- **Authorized official:** DR. BLANE MITCHELL CRANDALL M.D. (OWNER/PHYSICIAN)
- **Authorized official phone:** (239) 213-9111

## Contact information

- **Practice address:** 1012 GOODLETTE RD N, SUITE 101, NAPLES, FL 34102-5463
- **Practice address phone:** (239) 214-9111
- **Practice address fax:** (239) 330-1360
- **Mailing address:** 1012 GOODLETTE RD N, SUITE 101, NAPLES, FL 34102-5463
- **Mailing address phone:** (239) 214-9111
- **Mailing address fax:** (239) 330-1360

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME95903 | FL | Yes |

## Other

- **Enumeration date:** 03/23/2012
- **Last updated:** 03/23/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01893701 | BLUE CROSS BLUE SHIELD | FL |