Guillermo S Chang Licea, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11018690 Issued in FL

Practice address

2718 Lee Blvd Ste B
Lehigh Acres, FL 33971-1537

Phone

(239) 288-0840

Fax

(239) 244-2195

NPI assigned

May 11, 2022

Last updated

Jan 8, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Best Care Community and Family Health Center IncGroup PAC ID 2365877719, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Best Care Community and Family Health Center Inc

  • Community Health Clinic/Center
  • Lehigh Acres, FL
  • NPI 1700162468

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Best Care Community and Family Health Center Inc

  • Clinic/Center
  • Immokalee, FL
  • NPI 1538876933
  NPD (past)
• Best Care Family and Wellness Centers Inc

  • Psychiatry Physician
  • Lehigh Acres, FL
  • NPI 1093697583
  NPD (past)

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1568108546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 WHIPPOORWILL LN",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341053800",
            "telephone_number": "239-285-9046",
            "fax_number": "239-332-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718 LEE BLVD STE B",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339711537",
            "telephone_number": "239-288-0840",
            "fax_number": "239-244-2195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 S 1st St Unit Ab",
            "address_purpose": "LOCATION",
            "city": "Immokalee",
            "state": "FL",
            "postal_code": "341423950",
            "country_code": "US",
            "telephone_number": "239-867-4568",
            "fax_number": "239-307-2983",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3049 Cleveland Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339017049",
            "country_code": "US",
            "telephone_number": "239-332-0407",
            "fax_number": "239-332-0404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG LICEA",
        "first_name": "GUILLERMO",
        "middle_name": "S",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11018690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmin Cerrillo, RBT
• Dayani Cervantes
• Leyanis Cespedes Henriquez
• Sini Chacko, RN
• Tony Chan, PA-C
• Gissel Chang
• Chanun Park DO PA
• Ada Charleus
• Yaneisi Chaviano
• Deborah Louise Chenoweth, RPH

• Family Nurse Practitioner in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.