Individual provider Active NPI

Rodolfo Perez Gallardo, M.D.

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1821166604
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0066665 Issued in FL
Practice address
5225 Clayton CT
Fort Myers, FL 33907-2117
Phone
(239) 343-8240
Fax
(239) 343-8241
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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 ME0066665 FL Primary

Addresses

Primary practice location

5225 Clayton CT
Fort Myers, FL 33907-2117

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-8240

Other identifiers 1

IdentifierTypeStateIssuer
277170500MedicaidFL

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
I20070209000438 FL Practitioner - Family Practice 3173525714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1095 NW Saint Lucie W Blvd
Suite 104
Port Saint Lucie, FL 34986
Phone (772) 785-5511

Hospital & facility affiliations

  • Pinnacle Home Care Home health agency, Port Saint Lucie, FL, CCN 109610
  • Trilogy Home Healthcare Home health agency, Port Saint Lucie, FL, CCN 109270
  • Anchor Home Health Services, LLC Home health agency, Stuart, FL, CCN 107747
  • Visiting Nurse Association of Florida Inc Home health agency, Stuart, FL, CCN 107177
  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0066665FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Western Communities Family Practice Assoc Inc Family Medicine Past Accepting new patients

Locations

1095 NW Saint Lucie West Blvd
Ste 108
Port St Lucie, FL 34986
Phone (561) 785-5580

1095 NW Saint Lucie West Blvd
Ste 104
Port St Lucie, FL 34986
Phone (772) 785-5511

1095 NW Saint Lucie West Blvd
#L
Port St Lucie, FL 34986
Phone (772) 785-5595

509 SE Riverside Dr
Ste 305
Stuart, FL 34994
Phone (772) 221-2003

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Interoperability endpoints

  • Direct secure messaging: rperezgallardo2500960@direct.ccf.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1821166604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-8240",
            "fax_number": "239-343-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 CLAYTON CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072117",
            "telephone_number": "239-343-8240",
            "fax_number": "239-343-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ GALLARDO",
        "first_name": "RODOLFO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0066665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277170500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.