# ROYAL PALM PHYSICIAN GROUP, PA

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

## Provider details

- **NPI number:** 1912368556
- **Authorized official:** DR. KELLY A FONTANA MD (PRESIDENT)
- **Authorized official phone:** (239) 451-3143

## Contact information

- **Practice address:** 1585 PINE RIDGE RD STE 2, NAPLES, FL 34109-2105
- **Practice address phone:** (239) 451-3143
- **Practice address fax:** (239) 451-3145
- **Mailing address:** 1585 PINE RIDGE RD STE 2, NAPLES, FL 34109-2105
- **Mailing address phone:** (239) 451-3143
- **Mailing address fax:** (239) 451-3145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME98117 | FL | Yes |

## Other

- **Enumeration date:** 03/10/2016
- **Last updated:** 03/10/2016