FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. (NPI# 1417377813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417377813 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. |
| Practice Address |
316 Del Prado Blvd S Cape Coral FL 33990-1710 |
| Mailing Address |
Po Box 919771 Orlando FL 32891-9771 |
| Practice Telephone | 2393141616 |
| Practice Fax Number | 2397721613 |
| Mailing Telephone | 2392783600 |
| Mailing Fax Number | 2392783857 |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2020-10-12 |
| Authorized Official Name | FRANK MAZZEO JR. (PRESIDENT/CEO) |
| Authorized Official Telephone | 2392783600 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
PH29774 | FL | Suppliers |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 029570125 | 05 | |
| FL | 029570126 | 05 | |
| FL | BCBS | 99409 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356853154 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 1926 Victoria Ave, Fort Myers, FL 33901-3414 | 2017-11-02 |
| 1871946368 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 10501 Fgcu Blvd S, Fort Myers, FL 33965-6502 | 2016-07-20 |
| 1295145191 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 4300 Kings Hwy, Suite 210, Port Charlotte, FL 33980-2917 | 2014-04-30 |
| 1821412016 | Family Health Centers of Southwest Florida, Inc. | Pharmacy | 19701 S Tamiami Trl, Fort Myers, FL 33908-4818 | 2014-02-10 |
| 1366748402 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 3600 Broadway, Suite A, Fort Myers, FL 33901-8002 | 2011-02-08 |
| 1891005047 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 11921 Saradrienne Ln, Bonita Springs, FL 34135-5911 | 2010-10-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. | 2256 Heitman St, Fort Myers, FL 33901-3744 |
| Street Address |
316 DEL PRADO BLVD S |
| City | CAPE CORAL |
| State | FL |
| Zip Code | 33990-1710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699766949 | Tan-long Pham | Optometrist | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2005-11-03 |
| 1053930131 | Yasmin Akhlaghi | Student in an Organized Health Care Education/Training Program | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2020-04-09 |
| 1205321403 | Matthew Williams | Dentist | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2018-06-29 |
| 1497278857 | Anusha Mittapalli | Internal Medicine | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2017-07-18 |
| 1205295763 | Ana Beyra | Dentist | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2016-02-12 |
| 1548641814 | Lora B Moak | Dentist | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2015-06-12 |
| 1083026108 | Divya Panneerselvam | Pediatrics | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2014-05-22 |
| 1225467467 | Shahzaib Mirza | Pediatrics | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2013-11-07 |
| 1194151589 | Karen De Souza Ferreira Hunt | Family Medicine | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2013-09-18 |
| 1215377379 | Sharmila Tilak | Internal Medicine | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2013-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902462 | Shahida Rafiq | Pharmacist | 1619 Delprado Blvd, Cape Coral, FL 33990 | 2020-11-03 |
| 1386259208 | Hope of Life Medical Supply Corp | Durable Medical Equipment & Medical Supplies | 2328 Hancock Bridge Pkwy 1st Fl Ste 114-e, Cape Coral, FL 33990 | 2020-09-09 |
| 1669001814 | Jamie Lindon Kohl | Specialist/Technologist | 605 Se 13th Ct, Cape Coral, FL 33990 | 2020-04-08 |
| 1548809551 | Medical Risk Solutions | Family Medicine | 1020 Cultural Park Blvd, Cottage #7, Cape Coral, FL 33990 | 2019-12-23 |
| 1013495175 | Sunshine Assisted Living Home Care Facility. | Assisted Living Facility | 1422 Se 23rd Ter., Crape Coral, FL 33990 | 2018-08-01 |
| 1215429279 | Five Star Homecare LLC | Adult Companion | 629 Se 10th Pl, Cape Coral, FL 33990 | 2018-06-05 |
| 1730679192 | Amanda Tiana Bright | Developmental Therapist | 1507 Se 18th St, Cape Coral, FL 33990 | 2018-05-11 |
| 1487170908 | Natalie Diaz | Behavior Technician | 317 Se 16th Place, Cape Coral, FL 33990 | 2017-08-16 |
| 1679097273 | Centro Medico LLC | Clinic/Center | 1425 Viscaya Pkwy Ste 101, Cape Coral, FL 33990 | 2017-07-26 |
| 1629506308 | Besties LLC | Adult Companion | 518 Se 20th Ct, Cape Coral, FL 33990 | 2017-05-25 |
| Find all providers in zip 33990 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669010369 | Lee Memorial Health System | Clinic/Center | 650 Del Prado Blvd S Ste 107, Cape Coral, FL 33990-5629 | 2019-12-13 |
| 1972149508 | Lee Memorial Health Systems | Clinic/Center | 650 Del Prado Blvd S Ste 107, Cape Coral, FL 33990-5629 | 2019-11-19 |
| 1417304858 | Lee Memorial Health System | Clinic/Center | 1435 Se 8th Ter, Suite E, Cape Coral, FL 33990-3289 | 2016-05-16 |
| 1851552186 | Family Health Centers of Southwest Florida Inc | Clinic/Center | 305 Sw 2nd Ter, Cape Coral, FL 33991-1958 | 2008-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326132 | Foundcare Inc | Clinic/Center | 5867 Okeechobee Blvd, West Palm Beach, FL 33417-4344 | 2020-11-05 |
| 1720686355 | Mcr Health, Inc. | Clinic/Center | 170 N Lime Ave, Sarasota, FL 34237-6122 | 2020-10-15 |
| 1306452438 | Jessie Trice Community Health System Inc | Clinic/Center | 5361 Nw 22nd Ave # M1, Miami, FL 33142-8035 | 2020-09-23 |
| 1679185292 | Primary Care Medical Services of Poinciana Inc | Clinic/Center | 8600 W Irlo Bronson Memorial Hwy, Kissimmee, FL 34747-1001 | 2020-08-17 |
| 1992316285 | Central Florida Health Care, Inc. | Clinic/Center | 225 Lincoln Ave, Lake Wales, FL 33853-3546 | 2020-08-11 |
| 1902425028 | Lee Memorial Health System | Clinic/Center | 2525 Harbor Blvd Ste 204, Port Charlotte, FL 33952-5342 | 2020-04-09 |
| 1164051405 | Lee Memorial Health System | Clinic/Center | 2484 Caring Way Unit F, Port Charlotte, FL 33952-5306 | 2020-04-08 |
| 1750919791 | City of Dunedin | Clinic/Center | 1042 Virginia St, Dunedin, FL 34698-7325 | 2020-03-27 |
| 1407481039 | Primary Care Medical Services of Poinciana Inc | Clinic/Center | 4303 Cameron Preserve Cir, Kissimmee, FL 34746-6304 | 2020-03-04 |
| 1669012498 | Project Health Inc | Clinic/Center | 595 N Lecanto Hwy, Lecanto, FL 34461-9187 | 2020-01-09 |
| Find all providers with the same taxonomy | ||||
| City | CAPE CORAL |
| Zip Code | 33990 |
Please comment or provide details below to improve the information on FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC..
| 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.