Active NPI
Gemayel Lionel Aquino, D.D.S
- General Practice Dentistry
- Fort Myers, FL
National Provider Identifier
1063783694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN19270
- Practice address
- 12734 Kenwood LN Ste 45
Fort Myers, FL 33907 - Phone
- (239) 689-5436
- NPI assigned
- Jan 12, 2012
- Last updated
- Apr 30, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN19270 | FL | Primary |
Addresses
Primary practice location
12734 Kenwood LN Ste 45
Fort Myers, FL 33907
Mailing address
12734 Kenwood LN Ste 45
Fort Myers, FL 33907-5639
Phone (392) 689-5436
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN19270 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714435200000",
"number": "1063783694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12734 KENWOOD LN STE 45",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339075639",
"telephone_number": "392-689-5436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12734 KENWOOD LN STE 45",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33907",
"telephone_number": "239-689-5436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AQUINO",
"first_name": "GEMAYEL",
"middle_name": "LIONEL",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-12",
"last_updated": "2024-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN19270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.