Organization Active NPI

Prime Surgery Center Corporation

  • Surgery Physician
  • Fort Myers, FL
National Provider Identifier
1700778487
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PRIME SURGERY CENTER CORPORATION
Practice address
63 Barkley Cir
Fort Myers, FL 33907-4514
Phone
(954) 552-8476
NPI assigned
Jul 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Authorized official

Name
Justine O'Brien
Title
Manager
Phone
(954) 552-8476

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

63 Barkley Cir
Fort Myers, FL 33907-4514

Mailing address

201 N Pine Island Rd
Plantation, FL 33324-1819
Phone (954) 552-8476

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1700778487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N PINE ISLAND RD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241819",
            "telephone_number": "954-552-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 BARKLEY CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074514",
            "telephone_number": "954-552-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME SURGERY CENTER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "JUSTINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-552-8476"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 17, 2025; 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.