NPIMap

Organization Active NPI

Family Health Centers of Southwest Florida, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
National Provider Identifier
1124798418
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Practice address
4040 Palm Beach Blvd Ste a
Fort Myers, FL 33916-3470
Phone
(239) 344-2304
Fax
(239) 693-7494
NPI assigned
Sep 17, 2021
Last updated
May 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Authorized official

Name
Frank Mazzeo Jr., DDSNPI 1962597047
Title
President/Ceo
Phone
(239) 278-3600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4040 Palm Beach Blvd Ste a
Fort Myers, FL 33916-3470

Mailing address

PO Box 919771
Orlando, FL 32891-0001
Phone (239) 278-3600

Other identifiers 2

IdentifierTypeStateIssuer
101896OtherFLMEDICARE
056887201MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Family Health CTRS of SW FL29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

4040 Palm Beach Blvd
Ste A
Fort Myers, FL 33916
Phone (239) 344-2304

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1124798418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919771",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "239-278-3600",
            "fax_number": "239-479-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 PALM BEACH BLVD STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339163470",
            "telephone_number": "239-344-2304",
            "fax_number": "239-693-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-17",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "MAZZEO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "239-278-3600",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "101896",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056887201",
            "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 May 18, 2022; 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.