Individual provider Active NPI

Vicente Perez, APRN

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1023713971
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11025251 Issued in FL
Practice address
6811 Porto Fino Cir
Fort Myers, FL 33912-4354
Phone
(239) 208-6648
Fax
(239) 931-0221
NPI assigned
Mar 31, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11025251 FL Primary

Addresses

Primary practice location

6811 Porto Fino Cir
Fort Myers, FL 33912-4354

Mailing address

1220 Amherst St E
Lehigh Acres, FL 33974-0525
Phone (305) 926-1495

Other practice location 1

1220 Amherst St E
Lehigh Acres, FL 33974-0525
Phone (305) 926-1495

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240320000218 FL Practitioner - Nurse Practitioner 6204299688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Axel Health Primary Care LLCGroup PAC ID 9537568266, 2 clinicians

Practice addresses (Care Compare)

14192 Metropolis Ave
Fort Myers, FL 33912-4331
Phone (239) 313-2901

6811 Porto Fino Cir
Fort Myers, FL 33912-4354
Phone (239) 208-6648

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11025251FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
VG Primary Care PLLC CurrentSince Apr 1, 2024 Accepting new patients
Axel Health Primary Care LLC CurrentSince Oct 14, 2024 Accepting new patients

Locations

6811 Porto Fino Cir
Fort Myers, FL 33912
Phone (239) 225-1306

5285 Summerlin Rd
Ste 101
Fort Myers, FL 33919
Phone (239) 281-4908

14192 Metropolis Ave
Fort Myers, FL 33912
Phone (239) 244-9560

Organizations & group practices 2

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1023713971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 AMHERST ST E",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339740525",
            "telephone_number": "305-926-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6811 PORTO FINO CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124354",
            "telephone_number": "239-208-6648",
            "fax_number": "239-931-0221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 Amherst St E",
            "address_purpose": "LOCATION",
            "city": "Lehigh Acres",
            "state": "FL",
            "postal_code": "339740525",
            "country_code": "US",
            "telephone_number": "305-926-1495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "VICENTE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-31",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11025251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.