MR. ARNOLD WILLIAM FACKLAM III (NPI# 1356509129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356509129 |
| Entity Type | Individual |
| Full Name | MR. ARNOLD WILLIAM FACKLAM III |
| Credential | APRN |
| Practice Address |
5216 Clayton Court Fort Myers FL 33907 |
| Mailing Address |
P.o. Box 2147 Fort Myers FL 33902-2147 |
| Practice Telephone | 2393438260 |
| Practice Fax Number | 2393438261 |
| Mailing Telephone | 2393438260 |
| Mailing Fax Number | 2393438261 |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2020-09-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
APRN9420829 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | MEDICARE PTAN OBS ASSOCIATES U OF R | J400001352 | 01 |
| FL | 016126500 | 05 |
| Street Address |
5216 CLAYTON COURT |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205815818 | Rahul Kumar Challapalli | Internal Medicine | 5216 Clayton Court, Fort Myers, FL 33907 | 2006-01-11 |
| 1245473297 | Sagar Naik | Internal Medicine | 5216 Clayton Court, Fort Myers, FL 33907-2116 | 2009-04-07 |
| 1699832949 | Razak Abdul Dosani | Internal Medicine | 5216 Clayton Court, Fort Myers, FL 33907 | 2007-01-03 |
| 1093872392 | Abusayeed Muhammad Feroz | Specialist | 5216 Clayton Court, Fort Myers, FL 33907 | 2007-01-03 |
| 1912073321 | Janice Mary Kirk | Nurse Practitioner | 5216 Clayton Court, Fort Myers, FL 33907-2116 | 2006-11-28 |
| 1972532497 | Vijay Das | Internal Medicine | 5216 Clayton Court, Fort Myers, FL 33907 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739253 | Islande Dorcin | Social Worker | 13300 South Cleveland Ave Suite 56 # 822, Fort Myers, FL 33907 | 2020-08-04 |
| 1003462268 | Ronny Rodolfo Herrera | Behavior Technician | Beacon Executive Suites, 8359 Beacon Blvd, Suite#416, Homestead, FL 33907 | 2019-08-14 |
| 1528549094 | Deborah Senese Streater | Dentist | 12530 New Brittany Blvd., Fort Myers, FL 33907 | 2018-08-23 |
| 1437648391 | Rita Lusinete Rabitt | Registered Nurse | 14084 Clear Water Ln, Fort Myers, FL 33907 | 2018-05-07 |
| 1972092146 | Surgery Centre of Sw Florida LLC | Clinic/Center | 13051 University Dr Ste 102, Fort Myers, FL 33907 | 2018-05-03 |
| 1740787761 | Care Transport Inc | Non-emergency Medical Transport (VAN) | 7850 Reflection Cove Dr, Fort Myers, FL 33907 | 2018-04-06 |
| 1942730692 | Concierge Care of Fort Myers, LLC | In Home Supportive Care | 12253 New Brittany Boulevard, Suite 32, Fort Myers, FL 33907 | 2017-06-15 |
| 1710411467 | Johnnie Terrell | Social Worker | 43 Barkley Cir #102, Fort Myers, FL 33907 | 2017-04-19 |
| 1881041184 | Hchs Medical Center | Clinic/Center | 35 Barkley Circle, Unit 2, Fort Myers, FL 33907 | 2016-05-17 |
| 1043665227 | Tong Liu | Dentist | 8016 Summerlin Lakes Dr, Fort Myers, FL 33907 | 2016-04-26 |
| Find all providers in zip 33907 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447757547 | Douglas L Jarrett | Nurse Practitioner | 16261 Bass Rd Suite 300, Fort Myers, FL 33908 | 2018-04-06 |
| 1710317086 | Robert Mark Payne | Nurse Practitioner | 8255 College Pkwy Ste 200, Fort Myers, FL 33919-5119 | 2013-11-22 |
| 1356621338 | Care Practitioners LLC | Nurse Practitioner | 9174 River Otter Dr, Fort Myers, FL 33912-8920 | 2011-08-23 |
| 1306943758 | Nadine Elizabeth Gordon | Nurse Practitioner | 6360 Techster Blvd, Ste 1, Fort Myers, FL 33966-4805 | 2006-09-20 |
| 1891311916 | Elvira Ayupova | Nurse Practitioner | 9981 S Healthpark Dr, Fort Myers, FL 33908-3618 | 2020-06-24 |
| 1871142430 | Kelly Ann Brown | Nurse Practitioner | 5216 Clayton Ct, Fort Myers, FL 33907-2116 | 2019-09-06 |
| 1841751468 | Sandra Jean Craig | Nurse Practitioner | 13778 Plantation Rd, Fort Myers, FL 33912-4301 | 2019-03-27 |
| 1861963332 | Aimee Cassandra Routzong | Nurse Practitioner | 8960 Colonial Center Dr Ste 302, Fort Myers, FL 33905-7810 | 2018-12-10 |
| 1265907596 | Renato John Tolu | Nurse Practitioner | 8960 Colonial Center Dr Ste 302, Fort Myers, FL 33905-7810 | 2018-10-13 |
| 1467944116 | Clarice B Wei | Nurse Practitioner | 16261 Bass Rd Ste 300, Fort Myers, FL 33908 | 2018-05-30 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33907 |
Please comment or provide details below to improve the information on MR. ARNOLD WILLIAM FACKLAM III.
| 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.