Individual provider Active NPI

Emil A. Dameff, M.D.

  • Family Medicine Physician
  • Punta Gorda, FL
National Provider Identifier
1811035314
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME63276 Issued in FL
Practice address
3162 Willow Rd
Punta Gorda, FL 33982-3316
Phone
(941) 380-6022
Fax
(941) 575-1964
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME63276 FL Primary

Addresses

Primary practice location

3162 Willow Rd
Punta Gorda, FL 33982-3316

Mailing address

3162 Willow Rd
Punta Gorda, FL 33982-3316
Phone (941) 380-6022

Other identifiers 1

IdentifierTypeStateIssuer
258250300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090804000184 FL Practitioner - General Practice 8426101775 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME63276FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Medical Group LLC CurrentSince Oct 14, 2022 Accepting new patients
Peace River Tropical Medicine Inc Family Medicine CurrentSince Apr 1, 2000 Accepting new patients

Locations

21202 Olean Blvd
Ste C1
Port Charlotte, FL 33952
Phone (941) 889-7440

2500 Harbor Blvd
Pt Charlotte, FL 33952
Phone (941) 766-4122

21202 Olean Blvd
Ste C6
Pt Charlotte, FL 33952
Phone (941) 889-7440

733 E Olympia Ave
Punta Gorda, FL 33950
Phone (941) 216-0803

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1811035314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3162 WILLOW RD",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339823316",
            "telephone_number": "941-380-6022",
            "fax_number": "941-575-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3162 WILLOW RD",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339823316",
            "telephone_number": "941-380-6022",
            "fax_number": "941-575-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMEFF",
        "first_name": "EMIL",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME63276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258250300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

Verify at the official NPI Registry.