Individual provider Active NPI

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  • Family Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1104297621
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9237816 Issued in FL
Practice address
414 Cape Coral Pkwy E Ste 103
Cape Coral, FL 33904-8522
Phone
(239) 343-9888
Fax
(239) 468-7937
NPI assigned
Oct 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9237816 FL Primary

Addresses

Primary practice location

414 Cape Coral Pkwy E Ste 103
Cape Coral, FL 33904-8522

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9888

Other practice location 1

126 Del Prado Blvd N Ste 102
Cape Coral, FL 33909-2713
Phone (239) 772-3295

Other identifiers 1

IdentifierTypeStateIssuer
104265700MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151202001866 FL Practitioner - Nurse Practitioner 1759681455 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9237816FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System Current Accepting new patients
Lee Health System Inc CurrentSince Jan 23, 2025 Accepting new patients
Millennium Physician Group LLC CurrentSince Sep 30, 2019 Accepting new patients
Lee Memorial Health System CurrentSince Sep 13, 2024 Accepting new patients
Lee Health System Inc CurrentSince Jan 23, 2025 Accepting new patients
Lee Memorial Health System CurrentSince Sep 13, 2024 Accepting new patients
Millennium Physician Group LLC CurrentSince Sep 30, 2019 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

126 Del Prado Blvd N
Cape Coral, FL 33909
Phone (239) 772-8900

126 Del Prado Blvd N
Ste 102
Cape Coral, FL 33909
Phone (239) 772-8900

414 Cape Coral Pkwy E
Ste 103
Cape Coral, FL 33904

126 Del Prado Blvd N
Ste 101
Cape Coral, FL 33909
Phone (239) 772-3295

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: hclose412570@direct.leememorial.org

Organizations & group practices 7

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": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1104297621",
    "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": "239-343-9888",
            "fax_number": "239-468-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 CAPE CORAL PKWY E STE 103",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048522",
            "telephone_number": "239-343-9888",
            "fax_number": "239-468-7937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 Del Prado Blvd N Ste 102",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339092713",
            "country_code": "US",
            "telephone_number": "239-772-3295",
            "fax_number": "239-772-4219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOSE",
        "first_name": "HEATHER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9237816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104265700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.