SURGICAL SPECIALISTS OF SOUTHWEST FLORIDA P.A. (NPI# 1033103437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033103437 |
| Entity Type | Organization |
| Organization Name | SURGICAL SPECIALISTS OF SOUTHWEST FLORIDA P.A. |
| Other Organization Name | SURGICAL SPECIALISTS OF SOUTHWEST FLORIDA |
| Practice Address |
6821 Palisades Park Ct Suite 1 Fort Myers FL 33912-7131 |
| Practice Telephone | 2399368555 |
| Practice Fax Number | 2399365611 |
| Mailing Telephone | 2399368555 |
| Mailing Fax Number | 2399365611 |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2014-07-03 |
| Authorized Official Name | DR. GORDON D BURTCH (PRESIDENT) |
| Authorized Official Telephone | 2399368555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 052343700 | 05 |
| Other Name | Type Code |
|---|---|
| Surgical Specialists of Southwest Florida | Doing Business As Name - Organization |
| Street Address |
6821 PALISADES PARK CT SUITE 1 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33912-7131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457344277 | Gordon D Burtch | Surgery | 6821 Palisades Park Ct, Suite 1, Fort Myers, FL 33912-7131 | 2005-08-26 |
| 1902208358 | Emily Marie Randall | Physician Assistant | 6821 Palisades Park Ct, Suite 1, Fort Myers, FL 33912-7131 | 2014-09-17 |
| 1912184920 | Biju Koshy Thomas | Surgery | 6821 Palisades Park Ct, Suite 1, Fort Myers, FL 33912-7131 | 2008-01-22 |
| 1326003997 | Thad Kammerlocher | Surgery | 6821 Palisades Park Ct, Suite 1, Fort Myers, FL 33912-7131 | 2006-04-18 |
| 1932193364 | Jose F Manibo | Surgery | 6821 Palisades Park Ct, Suite 1, Fort Myers, FL 33912-7131 | 2005-08-31 |
| 1942294343 | Ajay Kalra | Surgery | 6821 Palisades Park Ct, Fort Myers, FL 33912-7131 | 2005-08-31 |
| 1447243134 | Anthony J D'angelo | Surgery | 6821 Palisades Park Ct, Suite 1, Fort Myers, FL 33912-7131 | 2005-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134684814 | Performance Health Surgery Center | Clinic/Center | 9500 Gulf Research Lane, Fort Myers, FL 33912 | 2019-02-06 |
| 1609351899 | Voa Lee County Health Care Facility, Inc. | Skilled Nursing Facility | 14750 Hope Center Loop, Ft. Myers, FL 33912 | 2018-10-03 |
| 1245719954 | Lauren Grimes | Pharmacist | 13711 S Tamiami Trail, Fort Myers, FL 33912 | 2018-08-13 |
| 1972080828 | Solaris Rehab, LLC | Clinic/Center | 14001 Metro Parkway, Fort Myers, FL 33912 | 2018-07-24 |
| 1467943803 | Marie Veronica Scott | Nurse Practitioner | 14015 Danpak Loop, Fort Myers, FL 33912 | 2018-05-22 |
| 1952892291 | Daniels Modern Dentistry, Pa | Dentist | 6871 Daniels Parkway, Suite 100, Fort Myers, FL 33912 | 2018-05-22 |
| 1295258994 | Julie Ann Jakobi | Counselor | 18 Quanery Court, Fort Myers, FL 33912 | 2017-07-25 |
| 1205359908 | Maria Reyes | Developmental Therapist | 8961 Daniels Center Drive Suite 401, Fort Myers, FL 33912 | 2017-07-25 |
| 1669919288 | Darinka Ruiz | Social Worker | 961 Daniels Center Drive, Suite 401, Fort Myers, FL 33912 | 2017-01-20 |
| 1730622598 | Valerie Starnes | Nurse Practitioner | 13411 Parker Commons Blvd Ste 101, Fort Myers, FL 33912 | 2016-11-28 |
| Find all providers in zip 33912 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063411841 | John Anthony Moss | Surgery | 6821 Palisades Park Ct Ste 1, Fort Myers, FL 33912-7131 | 2005-07-14 |
| 1144704800 | David Robert Merkle | Surgery | 6821 Palisades Park Ct Ste 1, Fort Myers, FL 33912-7131 | 2018-09-19 |
| 1801226956 | Rodrigo Ruiz-gamboa | Surgery | 8380 Riverwalk Park Blvd, Suite 100, Fort Myers, FL 33919-8758 | 2013-11-26 |
| 1124205349 | Vein Specialists At Royal Palm Square Inc | Surgery | 1510 Royal Palm Square Blvd, Ste. 101, Fort Myers, FL 33919-1068 | 2008-01-30 |
| 1588682728 | Joseph G Magnant | Surgery | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 | 2006-07-17 |
| 1619932753 | Vincent J Belcastro | Surgery | 21 Barkley Circle, Fort Myers, FL 33907 | 2006-04-20 |
| 1285612143 | Moutaa Benmaamer | Surgery | 8380 Riverwalk Park Blvd, Suite 100, Fort Myers, FL 33919 | 2006-01-02 |
| 1528045747 | Brian Daniel Kurland | Surgery | 13782 Plantation Rd, Unit103, Fort Myers, FL 33912-4462 | 2005-12-29 |
| 1659365435 | Michael Lee Novotney | Surgery | 8010 Summerlin Lakes Dr Ste 100, Fort Myers, FL 33907-1849 | 2005-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104394857 | George Scott Hall Sr. | Surgery | 9 Marsh Creek Rd, Fernandina Beach, FL 32034-6413 | 2018-11-09 |
| 1316413115 | Fox Vascular Experts, LLC | Surgery | 2699 Stirling Rd Ste A301302, Fort Lauderdale, FL 33312-6517 | 2018-10-18 |
| 1114417508 | Vascular Center of Naples Inc. | Surgery | 5490 Bryson Dr Ste 201, Naples, FL 34109 | 2018-05-11 |
| 1598267593 | Joseph D Stillword, Md | Surgery | 800 Zeagler Dr Ste 320, Palatka, FL 32177-3827 | 2018-03-06 |
| 1386157006 | Beatriz Lam | Surgery | 2001 West 68 St, Cvicu, Hialeah, FL 33016 | 2017-11-16 |
| 1811421092 | Sunrise Vascular Center | Surgery | 8555 Nw 165th Ter, Miami Lakes, FL 33016-6138 | 2017-04-14 |
| 1962891838 | Global Trauma Systems, Inc | Surgery | 126 Se Mira Lavella, Port Saint Lucie, FL 34984-6615 | 2015-01-15 |
| 1184013450 | Vas-q-lar, Inc | Surgery | 6187 Nw 167th St, Suite H13, Hialeah, FL 33015-4340 | 2015-01-09 |
| 1396147138 | Usa Vein Clinics of Miami, LLC | Surgery | 1711 E Hallandale Beach Blvd Ste B, Hallandale Beach, FL 33009-4621 | 2014-09-24 |
| 1114336021 | Florida Vein Center, Inc | Surgery | 6050 53rd Ave E Unit A, Bradenton, FL 34203-9700 | 2014-08-05 |
| Find all providers with the same taxonomy | ||||
| City | FORT MYERS |
| Zip Code | 33912 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.