Individual provider Active NPI

Juan Antonio Carmona, MD

  • Family Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1083153761
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ACN962 Issued in FL
Practice address
2307 Bolado Pkwy
Cape Coral, FL 33990-2712
Phone
(239) 424-8122
Fax
(239) 257-3827
NPI assigned
Feb 15, 2017
Last updated
Oct 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ACN962 FL Primary
Family Medicine Physician 207Q00000X 19664 PR

Addresses

Primary practice location

2307 Bolado Pkwy
Cape Coral, FL 33990-2712

Mailing address

2307 Bolado Pkwy
Cape Coral, FL 33990-2712
Phone (239) 424-8122

Other practice location 1

1708 Cape Coral Pkwy W Ste 4
Cape Coral, FL 33914-6985
Phone (239) 424-8122

Other practice location 2

2621 Cleveland Ave
Fort Myers, FL 33901-5802
Phone (239) 424-8122

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL carmonamedicalcenter@gmail.com Direct

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
I20171226000334 FL Practitioner - General Practice 7113189671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carmona Medical Care IncGroup PAC ID 4486076080, 8 clinicians

Practice addresses (Care Compare)

2307 Bolado Pkwy
Cape Coral, FL 33990-2712
Phone (239) 424-8122

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN962FLMDFamily Medicine Physician
19664PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carmona Medical Care Inc Family Medicine CurrentSince May 14, 2020 Accepting new patients
Mediadvantage Home Health Services Corp PastSince Apr 30, 2003 Accepting new patients

Locations

1708 Cape Coral Pkwy W
Ste 4
Cape Coral, FL 33914
Phone (239) 945-5940

2307 Bolado Pkwy
Cape Coral, FL 33990
Phone (239) 424-8122

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1083153761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 BOLADO PKWY",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902712",
            "telephone_number": "239-424-8122",
            "fax_number": "239-257-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 BOLADO PKWY",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902712",
            "telephone_number": "239-424-8122",
            "fax_number": "239-257-3827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1708 Cape Coral Pkwy W Ste 4",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339146985",
            "country_code": "US",
            "telephone_number": "239-424-8122",
            "fax_number": "239-257-3827",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2621 Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339015802",
            "country_code": "US",
            "telephone_number": "239-424-8122",
            "fax_number": "239-257-3827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMONA",
        "first_name": "JUAN",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-15",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ACN962",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "19664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "carmonamedicalcenter@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2307 Bolado Pkwy",
            "city": "Cape Coral",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339902712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.