NPIMap

Organization Active NPI

Sante Plus Medical Center

  • Clinic/Center
  • Immokalee, FL
National Provider Identifier
1407514904
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SANTE PLUS MEDICAL CENTER
Practice address
1502 Lake Trafford Rd
Immokalee, FL 34142-2618
Phone
(239) 900-9170
Fax
(239) 603-2377
NPI assigned
Dec 1, 2021
Last updated
Dec 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Authorized official

Name
Ricot Jeansimon
Title
Owner
Phone
(239) 603-2377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1502 Lake Trafford Rd
Immokalee, FL 34142-2618

Mailing address

3822 Broadway Ste a
Fort Myers, FL 33901-8148
Phone (239) 603-2377

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2289032Sante Plus Medical Center, Inc1502 Lake Trafford Road, Immokalee, FL 34142Certificate of waiverSep 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Sante Plus Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3822 Broadway
Ste A
Fort Myers, FL 33901
Phone (239) 274-3004

1502 Lake Trafford Rd
Immokalee, FL 34142
Phone (239) 657-6363

3400 Lee Blvd
Ste 102
Lehigh Acres, FL 33971
Phone (239) 893-4141

3155 Lake Worth Rd
Palm Springs, FL 33461
Phone (561) 439-8440

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1407514904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3822 BROADWAY STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018148",
            "telephone_number": "239-603-2377",
            "fax_number": "561-293-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 LAKE TRAFFORD RD",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341422618",
            "telephone_number": "239-900-9170",
            "fax_number": "239-603-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTE PLUS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "JEANSIMON",
        "authorized_official_first_name": "RICOT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-603-2377"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Immokalee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.