NPIMap

Organization Active NPI

Marbela Medical Wellness Inc

  • General Practice Physician
  • Fort Myers, FL
National Provider Identifier
1851766943
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN404 Issued in FL
Legal business name
MARBELA MEDICAL WELLNESS INC
Practice address
13774 Plantation Rd Ste 105
Fort Myers, FL 33912-4461
Phone
(239) 231-1342
NPI assigned
Dec 1, 2015
Last updated
Dec 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Authorized official

Name
Maryam Nabavi, MDNPI 1366655821
Title
Owner
Phone
(573) 421-7322

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
General Practice Physician 208D00000X ACN404 FL Primary

Addresses

Primary practice location

13774 Plantation Rd Ste 105
Fort Myers, FL 33912-4461

Mailing address

13774 Plantation Rd Ste 105
Fort Myers, FL 33912-4461
Phone (239) 231-1342

National Provider Directory

National Provider Directory

Locations

13774 Plantation Rd
Ste 105
Fort Myers, FL 33912
Phone (239) 231-1342

Practitioners & affiliated clinicians

Practitioners 2

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": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1851766943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13774 PLANTATION RD STE 105",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124461",
            "telephone_number": "239-231-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13774 PLANTATION RD STE 105",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124461",
            "telephone_number": "239-231-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARBELA MEDICAL WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "NABAVI",
        "authorized_official_first_name": "MARYAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-421-7322",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN404",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 1, 2015; 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.