Individual provider Active NPI

Salomon Levy Miranda, MD

  • Surgery Physician
  • Fort Myers, FL
National Provider Identifier
1164665055
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME140310 Issued in FL
Practice address
8380 Riverwalk Park Blvd Ste 100
Fort Myers, FL 33919
Phone
(239) 343-9960
Fax
(239) 343-9977
NPI assigned
Apr 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME140310 FL Primary

Addresses

Primary practice location

8380 Riverwalk Park Blvd Ste 100
Fort Myers, FL 33919

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9960

Other practice location 1

6201 Alliance Ln Ste 200
Fort Myers, FL 33912-7165
Phone (239) 343-9960

Other practice location 2

6201 Alliance Ln Ste 100
Fort Myers, FL 33912-7164
Phone (239) 343-1176

Other practice location 3

319 Canyon Ridge Dr
Richardson, TX 75080-1902
Phone (786) 218-7071

Other identifiers 1

IdentifierTypeStateIssuer
102855700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slevymiranda177045@Direct.leememorial.org Lee Memorial Health System

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
I20190530002678 FL Practitioner - General Surgery 3375867740 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2002
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)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

23450 Via Coconut PT
Estero, FL 34135-1877
Phone (239) 468-0120

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-2000

8380 Riverwalk Park Blvd
Suite 100
Fort Myers, FL 33919-8758
Phone (239) 343-9960

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)13
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME140310FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Jul 1, 2019 Accepting new patients
Lee Memorial Health System CurrentSince Jul 1, 2019 Accepting new patients

Locations

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

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

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

6201 Alliance Ln
Ste 200
Fort Myers, FL 33912
Phone (239) 343-1176

6201 Alliance Ln
Ste 100
Fort Myers, FL 33912
Phone (239) 343-1176

8380 Riverwalk Park Blvd
Ste 100
Fort Myers, FL 33919
Phone (239) 343-9960

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: slevymiranda177045@direct.leememorial.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1164665055",
    "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": "239-343-9960",
            "fax_number": "239-343-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 RIVERWALK PARK BLVD STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33919",
            "telephone_number": "239-343-9960",
            "fax_number": "239-343-9977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6201 Alliance Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339127165",
            "country_code": "US",
            "telephone_number": "239-343-9960",
            "fax_number": "239-343-6677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6201 Alliance Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339127164",
            "country_code": "US",
            "telephone_number": "239-343-1176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 Canyon Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750801902",
            "country_code": "US",
            "telephone_number": "786-218-7071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVY MIRANDA",
        "first_name": "SALOMON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-08",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME140310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102855700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slevymiranda177045@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.