Individual provider Active NPI

Alexander Gumiroff, MD

  • Obstetrics & Gynecology Physician
  • Fort Myers, FL
National Provider Identifier
1043505332
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME115034 Issued in FL
Practice address
13195 Metro Pkwy
#6-9
Fort Myers, FL 33966-4810
Phone
(239) 344-2348
Fax
(239) 479-5194
NPI assigned
Jun 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME115034 FL Primary

Addresses

Primary practice location

13195 Metro Pkwy
#6-9
Fort Myers, FL 33966-4810

Mailing address

PO Box 1357
Fort Myers, FL 33902-1357
Phone (239) 278-3600

Other identifiers 1

IdentifierTypeStateIssuer
008513300MedicaidFL

Other names 1

  • Dr. Alexander Gumirov Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130611000178 FL Practitioner - Obstetrics/Gynecology 3476792144 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Feb 10, 2020 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Feb 10, 2020 Accepting new patients
Family Health Centers of Southwest Florida Inc Past Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1043505332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1357",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339021357",
            "telephone_number": "239-278-3600",
            "fax_number": "239-226-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 METRO PKWY",
            "address_2": "#6-9",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664810",
            "telephone_number": "239-344-2348",
            "fax_number": "239-479-5194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMIROFF",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME115034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008513300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDER",
            "last_name": "GUMIROV",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.