Active NPI
Gulf Coast Certified Primary Care PA
- Health Maintenance Organization
- Bonita Springs, FL
National Provider Identifier
1275734816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- License
- OS8523
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.