NPIMap

Organization Active NPI

Gulf Coast Internal Medicine PA

  • Specialist
  • Fort Myers, FL
National Provider Identifier
1114125606
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME81543 Issued in FL
Legal business name
GULF COAST INTERNAL MEDICINE PA
Practice address
14131 Metropolis Avenue
Suite 106
Fort Myers, FL 33912-9383
Phone
(239) 561-8880
Fax
(239) 561-8890
NPI assigned
Jul 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Tanzeen Ahmed
Title
Owner
Phone
(239) 986-0259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME81543 FL Primary

Addresses

Primary practice location

14131 Metropolis Avenue
Suite 106
Fort Myers, FL 33912-9383

Mailing address

PO Box 6038
Fort Myers, FL 33911-6038
Phone (239) 561-8880

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12429/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1114125606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6038",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339116038",
            "telephone_number": "239-561-8880",
            "fax_number": "239-561-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14131 METROPOLIS AVENUE",
            "address_2": "SUITE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339129383",
            "telephone_number": "239-561-8880",
            "fax_number": "239-561-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "TANZEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-986-0259"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME81543",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.