NPIMap

Organization Active NPI

Gulf Shore Internal Medicine, P.a.

  • Internal Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1255501268
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS8532 Issued in FL
Legal business name
GULF SHORE INTERNAL MEDICINE, P.A.
Practice address
8991 Daniels Center Dr Ste 105
Fort Myers, FL 33912-0317
Phone
(239) 440-6456
Fax
(239) 236-0337
NPI assigned
Mar 5, 2008
Last updated
Nov 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Roderick Nassif, DONPI 1487748356
Title
Owner
Phone
(239) 440-6456

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
Internal Medicine Physician 207R00000X OS8532 FL Primary

Addresses

Primary practice location

8991 Daniels Center Dr Ste 105
Fort Myers, FL 33912-0317

Mailing address

PO Box 9279
Jupiter, FL 33468-9279
Phone (239) 440-6456

Other identifiers 2

IdentifierTypeStateIssuer
DF4682OtherPALMETTO GBA GROUP
K9799OtherFLMEDICARE GROUP

Other names 1

  • Roderick Nassif, D.O., P.A. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060508000209 FL Part B Supplier - Clinic/Group Practice 5294746129 Receives reassigned benefits from 15 practitioners
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

13691 Metro Pkwy
Ste 400
Fort Myers, FL 33912
Phone (239) 302-3216

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1255501268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9279",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334689279",
            "telephone_number": "239-440-6456",
            "fax_number": "239-236-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8991 DANIELS CENTER DR STE 105",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339120317",
            "telephone_number": "239-440-6456",
            "fax_number": "239-236-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF SHORE INTERNAL MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "NASSIF",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-440-6456",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS8532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA GROUP",
            "identifier": "DF4682",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "K9799",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roderick Nassif, D.O., P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Roderick Nassif, D.O., P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Nov 25, 2025; 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.