Organization
LIGHTHOUSE PEDIATRICS OF NAPLES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA GOODRIDGE SHEPARD M.D. (DOCTOR/PRACTICE CO-OWNER)
(239) 449-9882
Entity
Organization
Contact information
Practice address
3227 HORSESHOE DR S, NAPLES, FL 34104-6114
(239) 449-9882
(239) 449-9884
Mailing address
3227 HORSESHOE DR S, NAPLES, FL 34104-6114
(239) 449-9882
(239) 449-9884
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME076050
FL
2080A0000X
Pediatric Adolescent Medicine Physician
ME0053566
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048604300
—
FL
01
—
07336
BCBS
FL
01
—
1043264302
INDIVIDUAL NPI
—
01
—
1619918711
INDIVIDUAL NPI
—
05
—
254504700
—
FL
01
—
43843
BCBS
FL
Enumeration date
01/13/2015
Last updated
01/13/2015
Update your record
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