FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. (NPI# 1821412016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821412016 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. |
| Practice Address |
19701 S Tamiami Trl Fort Myers FL 33908-4818 |
| Mailing Address |
Po Box 919771 Orlando FL 32891-9771 |
| Practice Telephone | 2393141600 |
| Practice Fax Number | 2394256402 |
| Mailing Telephone | 2392783600 |
| Mailing Fax Number | 2392264650 |
| Enumeration Date | 2014-02-10 |
| 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 |
PH28479 | FL | Suppliers |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 029570117 | 05 | |
| FL | 029570124 | 05 |
| 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 |
| 1417377813 | Family Health Centers of Southwest Florida, Inc. | Pharmacy | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2014-04-24 |
| 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 |
19701 S TAMIAMI TRL |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33908-4818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972832095 | Ronald James Ramirez | Family Medicine | 19701 S Tamiami Trl, Fort Myers, FL 33908-4818 | 2009-12-19 |
| 1447742184 | Rafaella Sampaio | Dentist | 19701 S Tamiami Trl, Fort Myers, FL 33908-4818 | 2018-05-30 |
| 1952823379 | Malliany Camejo Leonor | Pediatrics | 19701 S Tamiami Trl, Fort Myers, FL 33908-4818 | 2017-07-07 |
| 1487028973 | Luis Rodriguez-riera | Dentist | 19701 S Tamiami Trl, Fort Myers, FL 33908-4818 | 2015-11-20 |
| 1013399039 | Taras Babiak | Family Medicine | 19701 S Tamiami Trl, Fort Myers, FL 33908 | 2015-06-25 |
| 1891069233 | Liza N Charles | Pediatrics | 19701 S Tamiami Trl, Fort Myers, FL 33908-4818 | 2012-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081806 | 1 Recovery | Community/Behavioral Health | 111 Daniels Dr, Fort Myers, FL 33908 | 2020-10-20 |
| 1457916462 | Avipharm, LLC | Pharmacy | 7669 Calistoble Loop, 2nd Floor, Fort Myers, FL 33908 | 2019-05-06 |
| 1013492289 | Craig M Stein | Pharmacist | 15236 Tropic Bird Court, Fort Myers, FL 33908 | 2018-10-03 |
| 1730665167 | Kyndra Lynn Petrick | Psychiatry & Neurology | 8560 Big Mangrove Dr, Fort Myers, FL 33908 | 2018-07-18 |
| 1447757547 | Douglas L Jarrett | Nurse Practitioner | 16261 Bass Rd Suite 300, Fort Myers, FL 33908 | 2018-04-06 |
| 1447754825 | Luis Daniel Ramos | General Practice | 15590 Ocean Walk Cir Apt 201, Fort Myers, FL 33908 | 2018-03-21 |
| 1619497062 | Vanesa Paola Vaquer | Dentist | 18070 S Tamiami Trl Ste 101, Fort Myers, FL 33908 | 2017-06-26 |
| 1962859603 | Teresa Ruiz | Behavior Technician | 15081 Woodrich Bend Ct Apt 416, Fort Myers, FL 33908 | 2016-05-23 |
| 1669865721 | Elena B. Alexiev | Dentist | 18070 S. Tamiami Trail, #101, Fort Myers, FL 33908 | 2015-03-13 |
| 1134488919 | Cecelia Anne Collins | Dietitian, Registered | 9215 Calle Arragon Avenue, Unit 205, Fort Myers, FL 33908 | 2012-05-14 |
| Find all providers in zip 33908 | ||||
| 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 |
|---|---|---|---|---|
| 1356853154 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 1926 Victoria Ave, Fort Myers, FL 33901-3414 | 2017-11-02 |
| 1891010393 | Family Health Centers of Southwest Florida Inc | Clinic/Center | 13195 Metro Parkway, Suites 6-9, Fort Myers, FL 33966-0000 | 2010-03-29 |
| 1942826623 | Lee Memorial Health System | Clinic/Center | 12550 New Brittany Blvd Ste 201, Fort Myers, FL 33907-3655 | 2020-06-18 |
| 1407472186 | Lee Memorial Health System | Clinic/Center | 12550 New Brittany Blvd Ste 100, Fort Myers, FL 33907-3655 | 2020-06-18 |
| 1013559343 | Lee Memorial Health System | Clinic/Center | 4751 S Cleveland Ave, Fort Myers, FL 33907-1317 | 2019-10-08 |
| 1538607031 | Lee Memorial Health System | Clinic/Center | 16271 Bass Rd, Fort Myers, FL 33908-3616 | 2017-02-03 |
| 1881131423 | Lee Memorial Health System | Clinic/Center | 4040 Palm Beach Blvd, Suite F, Fort Myers, FL 33916-3470 | 2017-01-20 |
| 1871946368 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 10501 Fgcu Blvd S, Fort Myers, FL 33965-6502 | 2016-07-20 |
| 1891142238 | Lee Memorial Health System | Clinic/Center | 3511 Dr Martin Luther King Blvd, Fort Myers, FL 33916-4651 | 2016-05-16 |
| 1366748402 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 3600 Broadway, Suite A, Fort Myers, FL 33901-8002 | 2011-02-08 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33908 |
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.