Theresa P Vergo, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9106207 Issued in FL

Practice address

3530 Kraft Rd Ste 300
Naples, FL 34105-5020

Phone

(239) 353-6636

Fax

(239) 354-1865

NPI assigned

Nov 21, 2011

Last updated

Jul 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Theresa P Formica Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Florida Cancer Specialists & Research Institute, LLC

  • Medical Oncology Physician
  • Cape Coral, FL
  • NPI 1760590962
  Medicare reassignment
• Inspire Oncology LLC

  • Radiation Oncology Physician
  • Naples, FL
  • NPI 1396352084
  Medicare reassignment
• Florida Cancer Specialists & Research Institute, LLC

  • Medical Oncology Physician
  • Bradenton, FL
  • NPI 1508973231
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1003183955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "392-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 KRAFT RD STE 300",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341055020",
            "telephone_number": "239-353-6636",
            "fax_number": "239-354-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGO",
        "first_name": "THERESA",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "FORMICA",
            "middle_name": "P",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathy Valerie Verdes, ARNP
• Laura Alejandra Vergara Campero, DMD
• Victor Vergara, DMD
• Laurent Elisa Vergel Cigarroa
• Ammi Elim Vergel Exposito
• Anthony Vernava, M.D.
• Devon Marie Verneuil, PA-C
• Vert of Naples Inc.
• Davis Vertin, OTR/L
• Rachel Marie Vesta, DNP, APRN, FNP-C

• Medical Physician Assistant in Naples, FL
• Providers in Naples, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.