IMMOKALEE FAMILY DOCTOR'S CLINIC, LLC (NPI# 1801157839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801157839 |
| Entity Type | Organization |
| Organization Name | IMMOKALEE FAMILY DOCTOR'S CLINIC, LLC |
| Practice Address |
555 N 15th St Suite A Immokalee FL 34142-2854 |
| Practice Telephone | 2396572779 |
| Practice Fax Number | 2396573335 |
| Mailing Telephone | 2396572779 |
| Mailing Fax Number | 2396573335 |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2014-06-02 |
| Authorized Official Name | DR. JUAN RIGOBERTO PUERTO (OWNER) |
| Authorized Official Telephone | 2396572779 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ME42490 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 068069900 | 05 |
| Street Address |
555 N 15TH ST SUITE A |
| City | IMMOKALEE |
| State | FL |
| Zip Code | 34142-2854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689682296 | Juan Rigoberto Puerto | Family Medicine | 555 N 15th St, Suite A, Immokalee, FL 34142-2854 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619432622 | Gabriels House of Care Fl. LLC | Acupuncturist | 212 South First St., Immokalee, FL 34142 | 2019-02-04 |
| 1851662472 | Seminole Tribe of Florida | Clinic/Center | 1120 S. First Street, Immokalee, FL 34142 | 2012-01-13 |
| 1881849826 | Michael Kane | Dentist | 1013 W. Main St., Unit 6a, Immokalee, FL 34142 | 2008-11-18 |
| 1699870485 | Jane J Darien | Social Worker | 425 North First St, Immokalee, FL 34142 | 2006-09-14 |
| 1659873891 | Dayna Sue Shull | Specialist/Technologist | 5050 Ave Maria Blvd, Ave Maria, FL 34142 | 2018-03-04 |
| 1457881922 | Immokalee Dental P.a. | Dentist | 1013 W. Main St., Unit 6a, Immokalee, FL 34142 | 2017-06-15 |
| 1063687838 | Alexandra Bianca Sarac | Pediatrics | 1441 Heritage Blvd, Immokalee, FL 34142 | 2008-04-23 |
| 1942391099 | Shameem Tamton | Pediatrics | 1454 Madison Ave W, Immokalee, FL 34142 | 2006-09-27 |
| 1215262977 | Mid State Mental Health Assessment Inc | Psychologist | 7052 Annunciation Circle, Suite 329, Ave Maria, FL 34142-0000 | 2009-10-13 |
| 1194343194 | Laury Garcia | Social Worker | 3511 Carson Lakes Cir, Immokalee, FL 34142-2092 | 2020-07-07 |
| Find all providers in zip 34142 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720047152 | Antonio Gonzalez | General Practice | 214 S 1st St, Unit C, Immokalee, FL 34142-3950 | 2006-03-23 |
| 1396107108 | Collier Health Services, Inc | General Practice | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2016-03-22 |
| 1770798688 | Collier Health Services Inc | General Practice | 1454 Madison Ave W, Immokalee, FL 34142-2200 | 2007-05-14 |
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| 1376140772 | Amy Wrenn | General Practice | 155 Cranes Roost Blvd Ste 2020-a, Altamonte Springs, FL 32701-3468 | 2020-10-08 |
| 1992302574 | Avita Medical Clinic, LLC | General Practice | 14831 N Florida Ave, Tampa, FL 33613-1825 | 2020-10-06 |
| 1568069672 | Ernesto Oscar Gonzalez Pupo | General Practice | 14420 Sw 22nd St, Miami, FL 33175-6338 | 2020-10-02 |
| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
| 1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
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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.