Individual provider Active NPI

Maria Barroso Cue

  • Family Psychologist
  • Fort Myers, FL
National Provider Identifier
1619321080
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family PsychologistTaxonomy code 103TF0000X
License
PY12463 Issued in FL
Practice address
15901 Bass Rd Ste 102
Fort Myers, FL 33908-3838
Phone
(239) 343-6050
Fax
(239) 343-6051
NPI assigned
Apr 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Family Psychologist 103TF0000X PY12463 FL Primary

Addresses

Primary practice location

15901 Bass Rd Ste 102
Fort Myers, FL 33908-3838

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-6050

Other practice location 1

8001 SW 36th St
Suite 9
Davie, FL 33328-1915
Phone (954) 577-7790

Other identifiers 1

IdentifierTypeStateIssuer
124784500MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118004142 FL Practitioner - Psychiatry 6305371014 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY12463FLMDFamily Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Dec 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Dec 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

3501 Health Center Blvd
Ste 2190
Estero, FL 34135
Phone (239) 468-0300

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

15901 Bass Rd
Ste 102
Fort Myers, FL 33908
Phone (239) 343-9890

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1619321080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-6050",
            "fax_number": "239-343-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15901 BASS RD STE 102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083838",
            "telephone_number": "239-343-6050",
            "fax_number": "239-343-6051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8001 SW 36th St",
            "address_2": "Suite 9",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333281915",
            "country_code": "US",
            "telephone_number": "954-577-7790",
            "fax_number": "954-577-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARROSO CUE",
        "first_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "FL",
            "license": "PY12463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124784500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.