NPIMap

Individual provider Active NPI

Colette Susan Haywood, M.D.

  • Family Medicine Physician
  • Lehigh Acres, FL
National Provider Identifier
1346545985
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME108878 Issued in FL
Practice address
3415 Lee Blvd
Lehigh Acres, FL 33971-1576
Phone
(239) 344-2305
Fax
(239) 368-2044
NPI assigned
Jan 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME108878 FL Primary

Addresses

Primary practice location

3415 Lee Blvd
Lehigh Acres, FL 33971-1576

Mailing address

PO Box 919771
Orlando, FL 32891-9771
Phone (239) 278-3600

Other identifiers 2

IdentifierTypeStateIssuer
14CS6OtherFLBCBS
003559400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110815000779 FL Practitioner - Family Practice 1254500952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers of Southwest Florida IncGroup PAC ID 3173432085, 37 clinicians

Practice addresses (Care Compare)

3415 Lee Blvd
Lehigh Acres, FL 33971-1576
Phone (844) 342-7935

Hospital & facility affiliations

  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of Southwest Florida Inc Current Accepting new patients
Family Health Centers of Southwest Florida, Inc. CurrentSince Jun 7, 2025 Accepting new patients

Locations

11921 Saradrienne Ln
Bonita Springs, FL 34135
Phone (239) 344-2322

11100 Summer Ridge Ln
Fort Myers, FL 33908
Phone (239) 344-2348

2232 Grand Ave
Fort Myers, FL 33901
Phone (239) 344-2330

3415 Lee Blvd
Fl 3
Lehigh Acres, FL 33971
Phone (239) 343-9935

3415 Lee Blvd
Lehigh Acres, FL 33971
Phone (239) 344-2305

3415 Lee Blvd
Fl 2
Lehigh Acres, FL 33971
Phone (239) 344-2385

4300 Kings Hwy
Ste 210
Port Charlotte, FL 33980
Phone (239) 344-2306

Organizations & group practices 12

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1346545985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919771",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919771",
            "telephone_number": "239-278-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 LEE BLVD",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711576",
            "telephone_number": "239-344-2305",
            "fax_number": "239-368-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "COLETTE",
        "middle_name": "SUSAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME108878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14CS6",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003559400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

Verify at the official NPI Registry.