Organization
NAPLES GYNECOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLANE MITCHELL CRANDALL M.D. (OWNER/PHYSICIAN)
(239) 213-9111
Entity
Organization
Contact information
Practice address
1012 GOODLETTE RD N, SUITE 101, NAPLES, FL 34102-5463
(239) 214-9111
(239) 330-1360
Mailing address
1012 GOODLETTE RD N, SUITE 101, NAPLES, FL 34102-5463
(239) 214-9111
(239) 330-1360
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME95903
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01893701
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/23/2012
Last updated
03/23/2012
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