CUSTOM LONGEVITY P.A.
NPI 1306312731
Internal Medicine in Naples, FL

Active since October 24, 2018
4005 GULF SHORE BLVD N APT 402, NAPLES, FL 34103(917) 292-8074 Get Directions Write a Review

NPPES record last updated: October 24, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Custom Longevity P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CUSTOM LONGEVITY P.A. (NPI 1306312731) is a healthcare organization registered as an internal medicine in Naples, Florida and active in the NPI registry since October 2018. The organization lists Svetlana Kogan, Owner, as its authorized official.

NPPES Registry Identity

NPI1306312731
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCUSTOM LONGEVITY P.A.
Location Address4005 GULF SHORE BLVD N APT 402Naples, FL 34103-3433
Mailing Address4005 Gulf Shore Blvd N Apt 402Naples, FL 34103-3433 · (917) 292-8074
Organization SubpartNo
Authorized OfficialSvetlana KoganOwner · (917) 292-8074
Enumeration DateOctober 24, 2018
NPI 1306312731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4005 GULF SHORE BLVD N APT 402, Naples, FL 34103

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
4005 GULF SHORE BLVD N APT 402
NAPLES, FL 34103

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Custom Longevity P.A.'s NPI number?

The NPI number for Custom Longevity P.A. is 1306312731. It was assigned to this organization in the NPPES registry on October 24, 2018.

Where is Custom Longevity P.A. located?

Custom Longevity P.A. is located at 4005 Gulf Shore Blvd N Apt 402, Naples, FL 34103. The listed phone number is (917) 292-8074.

What is Custom Longevity P.A.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Custom Longevity P.A. was last updated on October 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.