Individual provider Active NPI

Rafael Angel Pena Garcia, APRN, FNP-C

  • Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1033961453
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11032020 Issued in FL
Practice address
12651 Whitehall Dr
Fort Myers, FL 33907-3626
Phone
(239) 424-2030
Fax
(239) 343-4117
NPI assigned
Apr 2, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11032020 FL Primary

Addresses

Primary practice location

12651 Whitehall Dr
Fort Myers, FL 33907-3626

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-6202

Other practice location 1

9802 SW 138th Ave
Miami, FL 33186-6820
Phone (305) 850-5306

Other identifiers 1

IdentifierTypeStateIssuer
126764600MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpenagarcia667841@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

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
I20250513000968 FL Practitioner - Nurse Practitioner 1557889656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

12651 Whitehall Dr
Fort Myers, FL 33907-3626
Phone (239) 939-4444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11032020FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc Nurse Practitioner CurrentSince May 25, 2025 Accepting new patients
Lee Health System Inc CurrentSince May 25, 2025 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

12651 Whitehall Dr
Fort Myers, FL 33907
Phone (239) 424-2030

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

Interoperability endpoints

  • Direct secure messaging: rpenagarcia667841@direct.leememorial.org

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": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1033961453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-6202",
            "fax_number": "239-343-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12651 WHITEHALL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073626",
            "telephone_number": "239-424-2030",
            "fax_number": "239-343-4117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9802 SW 138th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331866820",
            "country_code": "US",
            "telephone_number": "305-850-5306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENA GARCIA",
        "first_name": "RAFAEL",
        "middle_name": "ANGEL",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-02",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11032020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126764600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpenagarcia667841@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.