Active NPI
Laurie J Desouza, ARNP
- Nurse Practitioner
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP1352572
- Practice address
- 13813 Metro Pkwy
Fort Myers, FL 33912-4343 - Phone
- (239) 936-1343
- Fax
- (239) 936-8507
- NPI assigned
- Apr 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP1352572 | FL | Primary |
Addresses
Primary practice location
13813 Metro Pkwy
Fort Myers, FL 33912-4343
Mailing address
PO Box 62707
Fort Myers, FL 33906-2707
Phone (239) 931-3440
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009264900 | Medicaid | FL | |
| Y8493 | Other | FL | FLORIDA BLUE |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Physician Group LLC | Current | Accepting new patients | |
| Millennium Physician Group LLC | Current | Accepting new patients | |
| Internal Medicine Associates of Lee County Hospitalist Group, LLC | Past | Accepting new patients | |
| Nancy M Troast DO PA | Past | Accepting new patients |
Locations
24600 S Tamiami Trl
Ste 400
Bonita Springs, FL 34134
Phone (239) 948-3761
13813 Metro Pkwy
Fort Myers, FL 33912
Phone (239) 936-1343
13691 Metro Pkwy
Ste 130
Fort Myers, FL 33912
Phone (239) 349-3539
2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700
3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108
4130 Tamiami Trl
Unit 100
Pt Charlotte, FL 33952
Phone (941) 629-4500
19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535
809 E Marion Ave
Punta Gorda, FL 33950
Phone (941) 625-1951
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Fort Myers, FL
- NPI 1811122880
-
- Family Medicine Physician
- Brooksville, FL
- NPI 1073131702
-
- Hospitalist Physician
- Fort Myers, FL
- NPI 1033402185
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1235290008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480896000000",
"number": "1487872826",
"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",
"fax_number": "239-931-3458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13813 METRO PKWY",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124343",
"telephone_number": "239-936-1343",
"fax_number": "239-936-8507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESOUZA",
"first_name": "LAURIE",
"middle_name": "J",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2016-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP1352572",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009264900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BLUE",
"identifier": "Y8493",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.