NPIMap

Organization Active NPI

Family Health Centers of Southwest Florida, Inc.

  • Clinic Pharmacy
  • Fort Myers, FL
National Provider Identifier
1790455087
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Practice address
2232 Grand Ave
Fort Myers, FL 33901-3717
Phone
(239) 344-2310
NPI assigned
Sep 17, 2021
Last updated
Jun 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Authorized official

Name
Frank Mazzeo Jr., DDANPI 1962597047
Title
President/Ceo
Phone
(239) 278-3600

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
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

2232 Grand Ave
Fort Myers, FL 33901-3717

Mailing address

PO Box 919771
Orlando, FL 32891-0001
Phone (239) 278-3600

Other identifiers 2

IdentifierTypeStateIssuer
104902000MedicaidFL
101884OtherFLMEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Debra C Skinner MD29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Practitioners & affiliated clinicians

Practitioners 1

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": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1790455087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919771",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "239-278-3600",
            "fax_number": "239-479-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 GRAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339013717",
            "telephone_number": "239-344-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-17",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "MAZZEO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "239-278-3600",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDA"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104902000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "101884",
            "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 Jun 21, 2022; 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.