NPIMap

Organization Active NPI

Children'S Gastroenterology of SW Florida

  • Pediatric Gastroenterology Physician
  • Fort Myers, FL
National Provider Identifier
1760629497
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
ME69256 Issued in FL
Legal business name
CHILDREN'S GASTROENTEROLOGY OF SW FLORIDA
Practice address
9800 S Healthpark Drive
Suite 145
Fort Myers, FL 33908
Phone
(239) 689-5100
NPI assigned
Jan 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Authorized official

Name
Christian Rosioru Ross, M.D.
Title
Member
Phone
(239) 689-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0206X ME69256 FL Primary

Addresses

Primary practice location

9800 S Healthpark Drive
Suite 145
Fort Myers, FL 33908

Mailing address

9800 S Healthpark Drive
Suite 145
Fort Myers, FL 33908
Phone (239) 689-5100

Other identifiers 1

IdentifierTypeStateIssuer
253328600MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1760629497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 S HEALTHPARK DRIVE",
            "address_2": "SUITE 145",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33908",
            "telephone_number": "239-689-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 S HEALTHPARK DRIVE",
            "address_2": "SUITE 145",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33908",
            "telephone_number": "239-689-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S GASTROENTEROLOGY OF SW FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "ROSIORU ROSS",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "239-689-5100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME69256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253328600",
            "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 Jan 16, 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.