Individual provider Active NPI

Manuella Constantino Sideropoulos, DO

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1093418238
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS22017 Issued in FL
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

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
126282900MedicaidFL

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
I20250413000018 FL Practitioner - Family Practice 3476077355 Reassigns benefits to 1 organization

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
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

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

OrganizationSpecialtyStatusNew patients
Lee Health System Inc Family Medicine CurrentSince Apr 3, 2025 Accepting new patients
Lee Health System Inc CurrentSince Apr 3, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.