Individual provider Active NPI

Petra Deem, APRN

  • Family Nurse Practitioner
  • Estero, FL
National Provider Identifier
1417543299
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11010048 Issued in FL
Practice address
8440 Murano del Lago Dr
Estero, FL 34135-8615
Phone
(239) 221-5402
Fax
(833) 411-0515
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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 APRN11010048 FL Primary

Addresses

Primary practice location

8440 Murano del Lago Dr
Estero, FL 34135-8615

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
111438200MedicaidFL

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
I20210823001543 FL Practitioner - Nurse Practitioner 3072918416 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11010048FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Sep 26, 2021 Accepting new patients
Lee Memorial Health System CurrentSince Sep 26, 2021 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Current Accepting new patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Oct 7, 2025 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Past Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

8440 Murano del Lago Dr
Estero, FL 34135
Phone (239) 221-5402

2780 Cleveland Ave
Fl 4
Fort Myers, FL 33901

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

8260 Gladiolus Dr
Fort Myers, FL 33908
Phone (239) 437-5755

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

2780 Cleveland Ave
Ste 702
Fort Myers, FL 33901
Phone (239) 332-6474

2780 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 334-5454

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8981 Colonial Center Dr
Fort Myers, FL 33905
Phone (239) 938-0800

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Freedom Health HMO Network

Organizations & group practices 7

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 2

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": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1417543299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8440 MURANO DEL LAGO DR",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "341358615",
            "telephone_number": "239-221-5402",
            "fax_number": "833-411-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEM",
        "first_name": "PETRA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11010048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111438200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

Verify at the official NPI Registry.