Caloosa Medical Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CALOOSA MEDICAL CENTER, LLC

Practice address

14651 Palm Beach Blvd Ste 100
Fort Myers, FL 33905-2331

Phone

(239) 849-6620

NPI assigned

Dec 17, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Clarennce A Scott, D.O.

Title

Managing Partner

Phone

(239) 849-6620

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1295373660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5180 JACKSON RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057518",
            "telephone_number": "239-849-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14651 PALM BEACH BLVD STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339052331",
            "telephone_number": "239-849-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALOOSA MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "CLARENNCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "239-849-6620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melecia Callum-Tyehimba
• Calm and Mindful Counseling
• Calm Reflections, LLC
• Calm Waters Counseling Group
• Caloosa Eye Center PA
• Calusa Behavior Solutions
• Calusa Recovery Services, LLC
• Kate Alexandra Calvert, CAA
• Rafael Andres Camacho Otero, DC
• Felipe Camacho, PHARM.D., RPH

• Family Medicine Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.