Guillermo Bohm, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

ME65227 Issued in FL

Practice address

4061 Bonita Beach Rd Ste 101
Bonita Springs, FL 34134-4073

Phone

(239) 301-0105

Fax

(239) 301-0110

NPI assigned

Jul 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Endocrinology Institute of South FL LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Bonita Springs, FL
  • NPI 1366855975
  Medicare reassignment NPD
• Internal Medicine Associates of Lee County Hospitalist Group, LLC

  • Hospitalist Physician
  • Fort Myers, FL
  • NPI 1033402185
  NPD (past)
• Internal Medicine Institute of South FL,LLC

  • Specialist
  • Naples, FL
  • NPI 1770997447
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1437157724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62707",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339062707",
            "telephone_number": "239-931-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 BONITA BEACH RD STE 101",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344073",
            "telephone_number": "239-301-0105",
            "fax_number": "239-301-0110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14131 Metropolis Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124455",
            "country_code": "US",
            "telephone_number": "239-301-0105",
            "fax_number": "239-301-0110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHM",
        "first_name": "GUILLERMO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME65227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374091900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "23687A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Blaquiere
• Ida D Blount, M.S.; LMFT
• Bmuc Holdings Inc
• Body Pain Medical Center, Inc.
• David R Boerkoel, OTR
• Roger Bohn, D.C.
• Chabely Bolet Reyes
• Bonita Beach Chiropractic, LLC
• Bonita Beach Medical Group LLC
• Bonita Community Health Center Inc

• Endocrinology, Diabetes & Metabolism Physician in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Endocrinology, Diabetes & Metabolism Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.