Southwest Florida Associates in Mental Health and Addictions, P.a.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

PY0003960 Issued in FL

Legal business name

SOUTHWEST FLORIDA ASSOCIATES IN MENTAL HEALTH AND ADDICTIONS, P.A.

Practice address

12657 New Brittany Blvd
Suite 12
Fort Meyers, FL 33907-3631

Phone

(239) 940-1804

Fax

(239) 275-3964

NPI assigned

Dec 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Charles Anthony, PHD

Title

President

Phone

(239) 940-1804

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261353600000",
    "number": "1689903650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12657 NEW BRITTANY BLVD",
            "address_2": "SUITE 12",
            "city": "FORT MEYERS",
            "state": "FL",
            "postal_code": "339073631",
            "telephone_number": "239-940-1804",
            "fax_number": "239-275-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12657 NEW BRITTANY BLVD",
            "address_2": "SUITE 12",
            "city": "FORT MEYERS",
            "state": "FL",
            "postal_code": "339073631",
            "telephone_number": "239-940-1804",
            "fax_number": "239-275-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST FLORIDA ASSOCIATES IN MENTAL HEALTH AND ADDICTIONS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-21",
        "last_updated": "2009-12-21",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-940-1804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "PY0003960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.