NPIMap

Organization Active NPI

Cardiology Consultants of Southwest Florida, Inc.

  • Cardiovascular Disease Physician
  • Fort Myers, FL
National Provider Identifier
1255437745
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOLOGY CONSULTANTS OF SOUTHWEST FLORIDA, INC.
Practice address
13411 Parker Commons Blvd
Suite 101
Fort Myers, FL 33912-1811
Phone
(239) 415-4900
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Authorized official

Name
Danna Miner
Title
Office Manager
Phone
(239) 415-4900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

13411 Parker Commons Blvd
Suite 101
Fort Myers, FL 33912-1811

Mailing address

13411 Parker Commons Blvd
Suite 101
Fort Myers, FL 33912-1811
Phone (239) 415-4900

Other practice location 1

2745 Lincoln Way
Clinton, IA 52732-7201
Phone (563) 244-2144

Other identifiers 1

IdentifierTypeStateIssuer
74817OtherFLBLUE CROSS GROUP

Other names 1

  • Cardiology Consultants of Clinton Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040831001335 FL Part B Supplier - Clinic/Group Practice 9335114552 Receives reassigned benefits from 8 practitioners
Practice locations: Fort Myers, FL
O20241011002899 IA Part B Supplier - Clinic/Group Practice 9335114552 Receives reassigned benefits from 3 practitioners
Practice locations: Clinton, IA

National Provider Directory

National Provider Directory

Locations

13411 Parker Commons Blvd
Ste 101
Fort Myers, FL 33912
Phone (239) 415-4900

Practitioners & affiliated clinicians

Practitioners 10

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": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1255437745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13411 PARKER COMMONS BLVD",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121811",
            "telephone_number": "239-415-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13411 PARKER COMMONS BLVD",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121811",
            "telephone_number": "239-415-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2745 Lincoln Way",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "IA",
            "postal_code": "527327201",
            "country_code": "US",
            "telephone_number": "563-244-2144",
            "fax_number": "563-244-2143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARDIOLOGY CONSULTANTS OF SOUTHWEST FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "MINER",
        "authorized_official_first_name": "DANNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "239-415-4900"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP",
            "identifier": "74817",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiology Consultants of Clinton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 20, 2024; 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.