FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. (NPI# 1891005047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891005047 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. |
| Practice Address |
11921 Saradrienne Ln Bonita Springs FL 34135-5911 |
| Mailing Address |
Po Box 919771 Orlando FL 32891-9771 |
| Practice Telephone | 2393442331 |
| Practice Fax Number | 2399491593 |
| Mailing Telephone | 2392783600 |
| Mailing Fax Number | 2392264650 |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2020-10-12 |
| Authorized Official Name | FRANK MAZZEO JR. (PRESIDENT/ CEO) |
| Authorized Official Telephone | 2392783600 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | 99409 | 01 | |
| FL | 056887205 | 05 | |
| FL | 029570106 | 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 |
| 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 |
| 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 |
11921 SARADRIENNE LN |
| City | BONITA SPRINGS |
| State | FL |
| Zip Code | 34135-5911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235399775 | Maria Espinoza Avila | Family Medicine | 11921 Saradrienne Ln, Suite 380, Bonita Springs, FL 34135-5911 | 2008-06-09 |
| 1164804233 | Eduardo Jose Moreno Arturo | Internal Medicine | 11921 Saradrienne Ln, Bonita Springs, FL 34135 | 2015-06-24 |
| 1700267911 | Javier A De La Cruz | Dentist | 11921 Saradrienne Ln, Bonita Springs, FL 34135-5911 | 2015-06-12 |
| 1376950329 | Maria Carolina Rico | Pediatrics | 11921 Saradrienne Ln, Bonita Springs, FL 34135-5911 | 2014-07-22 |
| 1881925949 | Viviana Carolina Cuberos-orozco | Family Medicine | 11921 Saradrienne Ln, Bonita Springs, FL 34135-5911 | 2010-01-28 |
| 1558518456 | Family Health Centers of Southwest Florida Inc | Clinic/Center | 11921 Saradrienne Ln, #8, Bonita Springs, FL 34135-5911 | 2008-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063022051 | Td Dental Group LLC | Clinic/Center | 28410 Crossing Blvd, Suit 230, Bonita Springs, FL 34135 | 2020-08-04 |
| 1619591096 | Lucinda Zagnoli | Counselor | 3501 Health Center Blvd Suite 2140, Bonita Springs, FL 34135 | 2020-06-02 |
| 1124649512 | Samantha S Wadas | Occupational Therapist | Solaris Rehab, LLC, 9520 Bonita Beach Rd Se, Bonita Springs, FL 34135 | 2020-04-27 |
| 1245710409 | Carrie Silverman | Hearing Instrument Specialist | 8951 Bonita Beach Rd Se Ste 240, Bonita Springs, FL 34135 | 2018-08-17 |
| 1124513593 | Lee Memorial Health System | Pharmacy | 23450 Via Coconut Point, Estero, FL 34135 | 2018-06-27 |
| 1801303540 | Lee Tasha Perez | Acupuncturist | 8840 Terrene Ct Ste 101, Bonita Springs, FL 34135 | 2018-01-03 |
| 1164942686 | Mind/mood Counseling & Coaching Centers of Swfl, Pllc | Community/Behavioral Health | 9990 Coconut Road, Attn. Emily - Bes Manager, Bonita Springs, FL 34135 | 2017-06-26 |
| 1699295691 | Alfa Brothers Group | Durable Medical Equipment & Medical Supplies | 28161 Pine Haven Way, Apt 135, Bonita Springs, FL 34135 | 2017-06-21 |
| 1992257919 | Lillian Mary Catherine Lienhardt | Physician Assistant | 27390 Tennesse Street, Bonita Springs, FL 34135 | 2016-10-25 |
| 1104277623 | American Spine & Orthopeadic Institute, LLC | Orthopaedic Surgery | 3501 Health Center Blvd Ste 2430, Bonita Springs, FL 34135 | 2016-06-27 |
| Find all providers in zip 34135 | ||||
| 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 |
|---|---|---|---|---|
| 1558518456 | Family Health Centers of Southwest Florida Inc | Clinic/Center | 11921 Saradrienne Ln, #8, Bonita Springs, FL 34135-5911 | 2008-08-21 |
| 1063673382 | Family Health Centers of Southwest Florida Inc | Clinic/Center | 26800 S Tamiami Trl, #150, Bonita Springs, FL 34134-4349 | 2008-06-19 |
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| 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 | BONITA SPRINGS |
| Zip Code | 34135 |
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.