Individual provider Active NPI

Damaris Espinosa

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1306436308
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11011106 Issued in FL
Practice address
12400 Brantley Commons CT
Fort Myers, FL 33907-5677
Phone
(239) 265-3451
NPI assigned
Jan 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11011106 FL Primary

Addresses

Primary practice location

12400 Brantley Commons CT
Fort Myers, FL 33907-5677

Mailing address

3323 SE 8TH PL
Cape Coral, FL 33904-4913
Phone (239) 265-3451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210421002027 FL Practitioner - Nurse Practitioner 3678981123 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11011106FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Galo Constante MD PA CurrentSince Mar 31, 2021 Accepting new patients

Locations

12400 Brantley Commons Ct
Fort Myers, FL 33907
Phone (239) 265-3451

12400 Brantley Commons Ct
Ste 1
Fort Myers, FL 33907
Phone (239) 275-9040

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1306436308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3323 SE 8TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339044913",
            "telephone_number": "239-265-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 BRANTLEY COMMONS CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075677",
            "telephone_number": "239-265-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOSA",
        "first_name": "DAMARIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11011106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.