Organization Active NPI

Giana Medical Center Clinica Hispana Corp

  • General Practice Physician
  • North Fort Myers, FL
National Provider Identifier
1194340018
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
GIANA MEDICAL CENTER CLINICA HISPANA CORP
Practice address
13240 N Cleveland Ave Ste 2-3
North Fort Myers, FL 33903-4855
Phone
(239) 599-4986
Fax
(239) 205-6101
NPI assigned
Jun 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Mrs. Ana Ivis Cabrera Gonzalez, APRN
Title
President
Phone
(239) 599-4986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

13240 N Cleveland Ave Ste 2-3
North Fort Myers, FL 33903-4855

Mailing address

13240 N Cleveland Ave Ste 2&3
North Fort Myers, FL 33903-4855
Phone (239) 599-4986

Other identifiers 1

IdentifierTypeStateIssuer
108349200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200817001391 FL Part B Supplier - Clinic/Group Practice 2062838477 Receives reassigned benefits from 2 practitioners
Practice locations: North Fort Myers, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2197009Giana Medical Center Clinica Hispana Corp13240 N Cleveland Ave Suite 2 & 3, Fort Myers, FL 33903Certificate of waiverOct 20, 2026

National Provider Directory

National Provider Directory

Locations

13240 N Cleveland Ave
Ste 2
North Fort Myers, FL 33903
Phone (239) 247-1304

13240 N Cleveland Ave
Ste 23
North Fort Myers, FL 33903
Phone (239) 599-4986

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1194340018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13240 N CLEVELAND AVE STE 2&3",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339034855",
            "telephone_number": "239-599-4986",
            "fax_number": "239-205-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13240 N CLEVELAND AVE STE 2-3",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339034855",
            "telephone_number": "239-599-4986",
            "fax_number": "239-205-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIANA MEDICAL CENTER CLINICA HISPANA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "CABRERA GONZALEZ",
        "authorized_official_first_name": "ANA IVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-599-4986",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108349200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.