NPIMap

Organization Active NPI

Internal Medicine Institute of South FL,LLC

  • Specialist
  • Naples, FL
National Provider Identifier
1770997447
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME109303 Issued in FL
Legal business name
INTERNAL MEDICINE INSTITUTE OF SOUTH FL,LLC
Practice address
12264 Tamiami TRL E Ste 203
Naples, FL 34113-7942
Phone
(239) 304-9071
Fax
(239) 304-9320
NPI assigned
Jun 20, 2014
Last updated
Jun 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Authorized official

Name
Rodolfo Freire, M.D.NPI 1861638280
Title
Medical Director
Phone
(239) 304-9071

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X ME109303 FL Primary

Addresses

Primary practice location

12264 Tamiami TRL E Ste 203
Naples, FL 34113-7942

Mailing address

4061 Bonita Beach Rd Ste 101
Bonita Springs, FL 34134-4073
Phone (239) 304-9071

Other identifiers 2

IdentifierTypeStateIssuer
14HA1OtherFLBC& BS
005826000MedicaidFL

National Provider Directory

National Provider Directory

Locations

4061 Bonita Beach Rd
Ste 101
Bonita Springs, FL 34134
Phone (239) 301-0105

Practitioners & affiliated clinicians

Practitioners 10

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": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1770997447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4061 BONITA BEACH RD STE 101",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344073",
            "telephone_number": "239-304-9071",
            "fax_number": "239-304-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12264 TAMIAMI TRL E STE 203",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341137942",
            "telephone_number": "239-304-9071",
            "fax_number": "239-304-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE INSTITUTE OF SOUTH FL,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "FREIRE",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "239-304-9071",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME109303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC& BS",
            "identifier": "14HA1",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005826000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.