Organization Active NPI

Gulf Coast Certified Primary Care PA

  • Health Maintenance Organization
  • Bonita Springs, FL
National Provider Identifier
1275734816
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
OS8523 Issued in FL
Legal business name
GULF COAST CERTIFIED PRIMARY CARE PA
Practice address
3384 Woods Edge Cir Ste 103
Bonita Springs, FL 34134-1367
Phone
(239) 498-5760
Fax
(239) 498-5763
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Authorized official

Name
Dr. Scott H Jaffe, D.O.
Title
President
Phone
(239) 498-5760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X OS8523 FL Primary

Addresses

Primary practice location

3384 Woods Edge Cir Ste 103
Bonita Springs, FL 34134-1367

Mailing address

3384 Woods Edge Cir Ste 103
Bonita Springs, FL 34134-1367
Phone (239) 498-5760

National Provider Directory

National Provider Directory

Locations

3384 Woods Edge Cir
Ste 103
Bonita Springs, FL 34134
Phone (239) 498-5760

10915 Bonita Beach Rd SE
Ste 1122
Bonita Springs, FL 34135

710 Pondella Rd
Ste 12
North Fort Myers, FL 33903

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307059200000",
    "number": "1275734816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3384 WOODS EDGE CIR STE 103",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341341367",
            "telephone_number": "239-498-5760",
            "fax_number": "239-498-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3384 WOODS EDGE CIR STE 103",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341341367",
            "telephone_number": "239-498-5760",
            "fax_number": "239-498-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST CERTIFIED PRIMARY CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2011-06-03",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-498-5760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "OS8523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; 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.