Physicians Medical Group of Southwest Florida,LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS002373 Issued in FL

Legal business name

PHYSICIANS MEDICAL GROUP OF SOUTHWEST FLORIDA,LLC

Practice address

3800 Colonial Blvd Ste 200
Fort Myers, FL 33966-1075

Phone

(239) 936-1233

Fax

(239) 936-8576

NPI assigned

Aug 14, 2013

Organization subpart

No

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

Authorized official

Name

Barry K Butler, MDNPI 1770581449

Title

Medical Director

Phone

(239) 936-1233

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Barry Butler, MD

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1770581449

  Family Medicine, FL

  Medicare reassignment Care Compare group NPD Authorized official
• Aaron Fralicker, APRN - AUTONOMOUS

  • Nurse Practitioner
  • Fort Myers, FL
  • NPI 1427597244

  FL

  Medicare reassignment Care Compare group NPD
• Mikayla Otzko

  • Physician Assistant
  • Cape Coral, FL
  • NPI 1548132863

  FL

  Medicare reassignment Care Compare group NPD
• Bradley W. Price, D.C.

  • Chiropractor
  • Fort Myers, FL
  • NPI 1588630701
  NPD
• Tammara Bezanson, APRN

  • Nurse Practitioner
  • Fort Myers, FL
  • NPI 1598752586
  NPD (past)
• Thomas Sievert, D.C.

  • Chiropractor
  • Fort Myers, FL
  • NPI 1245280064
  NPD (past)

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1104259035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 COLONIAL BLVD STE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661075",
            "telephone_number": "239-936-1233",
            "fax_number": "239-936-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 COLONIAL BLVD STE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661075",
            "telephone_number": "239-936-1233",
            "fax_number": "239-936-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS MEDICAL GROUP OF SOUTHWEST FLORIDA,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-14",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "239-936-1233",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS002373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rameez Hassan Phulpoto, MD
• Physical Therapy Assoc of Lee Co
• Physical Therapy Now Fort Myers
• Physicians for Quality Healthcare, Inc.
• Physicians for Quality Healthcare, Inc.
• Physicians Primary Care of S.W. Fla
• Physicians Primary Care of Southwest Florida PL
• Physicians Primary Care of Southwest Florida, PL
• Physicians Primary Care of Southwest Florida, PL
• Physicians Primary Care of Southwest Florida, PL

• All providers in Fort Myers, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.