Riverside Family Practice PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

RIVERSIDE FAMILY PRACTICE PA

Practice address

14651 Palm Beach Blvd
Fort Myers, FL 33905-2331

Phone

(239) 694-7887

Fax

(239) 694-8941

NPI assigned

Apr 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Peter Lautenbach, DONPI 1447214374

Title

Owner

Phone

(239) 694-7887

Specialties & licenses 1

Addresses

Practitioners 2

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

• Peter Lautenbach, DO

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1447214374
  NPD (past) Authorized official
• Douglas S Hughes, D.O.

  • Family Medicine Physician
  • Estero, FL
  • NPI 1740262542
  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1649233545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51589",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339941589",
            "telephone_number": "239-694-7887",
            "fax_number": "239-694-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14651 PALM BEACH BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339052331",
            "telephone_number": "239-694-7887",
            "fax_number": "239-694-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "LAUTENBACH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-694-7887",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isara De la Caridad Rivero Garcia, RBT
• Dustin Ryan Rivers, MD
• Glenn Rivers Jr., RN
• Michelle Papadopoulos Rivers, MD
• Trey Allen Rivers
• Riverwalk Anesthesia LLC
• Riverwalk ASC, LLC
• Riverwalk Endoscopy and Surgery Center LLC
• Riverwalk Surgery Center, Inc
• Amanda Kayla Rivkin, MA, BCBA

• 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 11, 2008; 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.