NPIMap

Organization Active NPI

Wittenborn Plastic Surgery LLC

  • Plastic Surgery Physician
  • Fort Myers, FL
National Provider Identifier
1639333115
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
87881 Issued in FL
Legal business name
WITTENBORN PLASTIC SURGERY LLC
Practice address
14131 Metropolis Ave Ste 105
Fort Myers, FL 33912-4332
Phone
(239) 561-2313
Fax
(888) 500-2420
NPI assigned
Jul 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Authorized official

Name
Dr. William Scott Wittenborn, M.D.NPI 1710983218
Title
Owner
Phone
(239) 561-2313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 87881 FL Primary

Addresses

Primary practice location

14131 Metropolis Ave Ste 105
Fort Myers, FL 33912-4332

Mailing address

13300 S Cleveland Ave Ste 56
#261
Fort Myers, FL 33907-3871
Phone (239) 561-2313

Other identifiers 1

IdentifierTypeStateIssuer
71645XOtherFLMEDICARE

National Provider Directory

National Provider Directory

Locations

14131 Metropolis Ave
Ste 105
Fort Myers, FL 33912
Phone (239) 561-2313

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": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1639333115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13300 S CLEVELAND AVE STE 56",
            "address_2": "#261",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073871",
            "telephone_number": "239-561-2313",
            "fax_number": "888-500-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14131 METROPOLIS AVE STE 105",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124332",
            "telephone_number": "239-561-2313",
            "fax_number": "888-500-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITTENBORN PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "WITTENBORN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-561-2313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "87881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "71645X",
            "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 May 6, 2009; 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.