Mouracade Recovery Medicine, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME64887 Issued in FL

Legal business name

MOURACADE RECOVERY MEDICINE, PLLC

Practice address

6290 Corporate CT Ste C201
Fort Myers, FL 33919-3503

Phone

(239) 406-6039

Fax

(239) 320-6796

NPI assigned

Feb 13, 2016

Last updated

Mar 12, 2024By 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

Dr. Mary Margaret Magno Mouracade, MD

Title

Principal

Phone

(239) 222-0700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1455321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1447619887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6290 CORPORATE CT STE C201",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193503",
            "telephone_number": "239-406-6039",
            "fax_number": "239-320-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6290 CORPORATE CT STE C201",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193503",
            "telephone_number": "239-406-6039",
            "fax_number": "239-320-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOURACADE RECOVERY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-13",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "MOURACADE",
        "authorized_official_first_name": "MARY MARGARET",
        "authorized_official_middle_name": "MAGNO",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "239-222-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME64887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajkumar Mothe
• Amy Lynn Mott, O.D.
• Marlene S Moulton, M.D.
• William A Moulton III, MA. MA.ED.
• Heather L Moulzolf, ARNP
• Mary Magno Mouracade, M.D.
• Mourad Health LLC
• Mathew Robert Mouritsen, DMD
• Laraine M Mouthaan, ARNP
• Move Pediatric Physical Therapy, LLC

• Internal Medicine Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.