Southwest Florida Endoscopy

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTHWEST FLORIDA ENDOSCOPY

Practice address

5050 Mason Corbin CT
Fort Myers, FL 33907-4541

Phone

(239) 275-6678

NPI assigned

Mar 13, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jansi R Prabakaran, M.D.

Title

President

Phone

(239) 275-6678

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366575292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 MASON CORBIN CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074541",
            "telephone_number": "239-275-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 MASON CORBIN CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074541",
            "telephone_number": "239-275-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST FLORIDA ENDOSCOPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRABAKARAN",
        "authorized_official_first_name": "JANSI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-275-6678",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Southwest Florida Eye Care, L.L.C
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• Southwest Florida Fertility Center PA
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• Ambulatory Surgical Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.