NPIMap

Organization Active NPI

Florida Id Care LLC

  • Infectious Disease Physician
  • Fort Myers, FL
National Provider Identifier
1245596964
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME100391 Issued in FL
Legal business name
FLORIDA ID CARE LLC
Practice address
3540 Stuart CT
Fort Myers, FL 33901-7737
Phone
(609) 350-4757
Fax
(239) 244-9481
NPI assigned
Apr 6, 2012
Last updated
Apr 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Authorized official

Name
Dr. Sivakumar RamanNPI 1245239011
Title
Medical Director
Phone
(239) 245-8223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X ME100391 FL Primary

Addresses

Primary practice location

3540 Stuart CT
Fort Myers, FL 33901-7737

Mailing address

14192 Metropolis Ave
Fort Myers, FL 33912-4331
Phone (239) 245-8223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121231000081 FL Part B Supplier - Clinic/Group Practice 4587817416 Receives reassigned benefits from 18 practitioners
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

13670 Metropolis Ave
Ste 106
Fort Myers, FL 33912
Phone (239) 444-8969

14192 Metropolis Ave
Fort Myers, FL 33912
Phone (239) 244-9560

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1245596964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14192 METROPOLIS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124331",
            "telephone_number": "239-245-8223",
            "fax_number": "239-244-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 STUART CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017737",
            "telephone_number": "609-350-4757",
            "fax_number": "239-244-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA ID CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "RAMAN",
        "authorized_official_first_name": "SIVAKUMAR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "239-245-8223",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME100391",
            "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 Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.