Active NPI
Manuella Constantino Sideropoulos, DO
- Family Medicine Physician
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS22017
- Practice address
- 2780 Cleveland Ave Ste 709
Fort Myers, FL 33901-5857 - Phone
- (239) 343-3831
- Fax
- (239) 343-2301
- NPI assigned
- Mar 27, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS22017 | FL | Primary |
Addresses
Primary practice location
2780 Cleveland Ave Ste 709
Fort Myers, FL 33901-5857
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-3831
Other practice location 1
3833 Schoolhouse Rd E Apt 6
Fort Myers, FL 33916-7723
Phone (239) 340-4368
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126282900 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2780 Cleveland Ave
Suite 709
Fort Myers, FL 33901-5857
Phone (239) 343-3831
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee Health System Inc | Family Medicine | Current | Accepting new patients |
| Lee Health System Inc | Current | Accepting new patients |
Locations
1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900
2441 Surfside Blvd
Ste 200
Cape Coral, FL 33914
Phone (239) 541-7500
1682 NE Pine Island Rd
Cape Coral, FL 33909
Phone (239) 424-1600
23450 Via Coconut Pt
Estero, FL 34135
Phone (239) 468-0150
3501 Health Center Blvd
Ste 1050
Estero, FL 34135
Phone (239) 468-0260
8960 Colonial Center Dr
Ste 300
Fort Myers, FL 33905
Phone (239) 343-9470
2780 Cleveland Ave
Ste 709
Fort Myers, FL 33901
Phone (239) 343-2551
4771 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 343-9800
13340 Metro Pkwy
Ste 100
Fort Myers, FL 33966
Phone (239) 343-0490
9131 College Pointe Ct
Fort Myers, FL 33919
Phone (239) 343-9100
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Interoperability endpoints
- mconstantino330123@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.
-
- Community/Retail Pharmacy
- Bonita Springs, FL
- NPI 1699510925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771286400000",
"number": "1093418238",
"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": "239-343-3831",
"fax_number": "239-343-2301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2780 CLEVELAND AVE STE 709",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339015857",
"telephone_number": "239-343-3831",
"fax_number": "239-343-2301"
}
],
"practiceLocations": [
{
"address_1": "3833 Schoolhouse Rd E Apt 6",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339167723",
"country_code": "US",
"telephone_number": "239-340-4368",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CONSTANTINO SIDEROPOULOS",
"first_name": "MANUELLA",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-27",
"last_updated": "2026-02-17",
"certification_date": "2026-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS22017",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126282900",
"state": "FL"
}
],
"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 Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.