Organization Active NPI

The Med Spa LLC

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1508741802
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
THE MED SPA LLC
Practice address
9924 Gulf Coast Main St # A120
Fort Myers, FL 33913-9026
Phone
(239) 295-8767
NPI assigned
Aug 7, 2025
Last updated
Aug 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Authorized official

Name
Kamila TursiNPI 1619452877
Title
Owner
Phone
(239) 822-2088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

9924 Gulf Coast Main St # A120
Fort Myers, FL 33913-9026

Mailing address

9924 Gulf Coast Main St # A120
Fort Myers, FL 33913-9026

National Provider Directory

National Provider Directory

Locations

9924 Gulf Coast Main St
#A120
Fort Myers, FL 33913
Phone (239) 295-8767

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1508741802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9924 GULF COAST MAIN ST # A120",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339139026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9924 GULF COAST MAIN ST # A120",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339139026",
            "telephone_number": "239-295-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MED SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "TURSI",
        "authorized_official_first_name": "KAMILA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-822-2088"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 7, 2025; 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.