Southwest Florida Facial Plastic Surgery Associates Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME81906 Issued in FL

Legal business name

SOUTHWEST FLORIDA FACIAL PLASTIC SURGERY ASSOCIATES INC.

Practice address

9407 Cypress Lake Dr Ste a
Fort Myers, FL 33919-0910

Phone

(239) 473-7390

NPI assigned

Oct 6, 2008

Last updated

May 20, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephen A Prendiville, M.D.NPI 1558309054

Title

President

Phone

(239) 437-3900

Specialties & licenses 1

Addresses

Locations

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.

• Stephen A Prendiville, M.D.

  • Specialist
  • Fort Myers, FL
  • NPI 1558309054
  Authorized official Same address or phone

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1245481597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9407 CYPRESS LAKE DR STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339190910",
            "telephone_number": "239-473-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9407 CYPRESS LAKE DR STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339190910",
            "telephone_number": "239-473-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST FLORIDA FACIAL PLASTIC SURGERY ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-06",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "PRENDIVILLE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-437-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME81906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.