Royal Palm Medical Group Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ROYAL PALM MEDICAL GROUP INC

Practice address

2665 Cleveland Ave Ste 102
Fort Myers, FL 33901-5884

Phone

(239) 313-6300

Fax

(239) 689-5524

NPI assigned

Jan 28, 2010

Organization subpart

No

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

Authorized official

Name

Lazaro Gonzalez, APRN

Title

Owner

Phone

(239) 313-6300

Specialties & licenses 3

Addresses

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vivian M Rodriguez

  • Contractor
  • Cape Coral, FL
  • NPI 1821336884
  NPD
• Lourders M Sardinas, MT

  • Massage Therapist
  • Fort Myers, FL
  • NPI 1669703765
  NPD (past)

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

{
    "created_epoch": "1264636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1487985610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 CLEVELAND AVE STE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015884",
            "telephone_number": "239-313-6300",
            "fax_number": "239-689-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 CLEVELAND AVE STE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015884",
            "telephone_number": "239-313-6300",
            "fax_number": "239-689-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL PALM MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-28",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "LAZARO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-313-6300",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "MM24026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Nextgen",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2665 Cleveland Ave Ste 102",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chantel A Roy, RPH
• Courtney Marie Roy
• Kristine Roy, APRN
• Tricia Renee Roy, LMT, NCTMB
• Royal Hands Chiropractic and Wellness Inc
• Royalty Care Home Health Services LLC
• Ariel Taylor Rozanski, PT DPT
• Travisjah Rozier
• Simon Rozowsky, MD
• RRC Vascular Specialists Inc

• Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.