Individual provider Active NPI

Zoe Tan Pereda, MD

  • General Practice Physician
  • Port Charlotte, FL
National Provider Identifier
1942053467
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1737 Issued in FL
Practice address
17801 Murdock Cir Unit C
Port Charlotte, FL 33948-4003
Phone
(941) 629-3500
NPI assigned
Apr 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ACN1737 FL Primary

Addresses

Primary practice location

17801 Murdock Cir Unit C
Port Charlotte, FL 33948-4003

Mailing address

12839 Ivory Stone Loop
Fort Myers, FL 33913-6744
Phone (239) 202-3941

Other practice location 1

110 NE 2nd Pl Ste 106
Cape Coral, FL 33909-2553
Phone (239) 244-2917

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
I20260202002664 FL Practitioner - General Practice 1557849395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David a Butler DO LLCGroup PAC ID 5092981118, 15 clinicians

Practice addresses (Care Compare)

2400 Harbor Blvd
Port Charlotte, FL 33952-5038
Phone (941) 273-3611

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Port Charlotte, FL, CCN 108270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN1737FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Family Care Group CurrentSince Jan 1, 2026 Accepting new patients
David a Butler DO LLC PastSince May 9, 2026 Accepting new patients
Florida Physicians Partners Group LLC General Practice Past Accepting new patients

Locations

110 NE 2nd Pl
Ste 106
Cape Coral, FL 33909
Phone (239) 244-2917

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 1

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": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1942053467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12839 IVORY STONE LOOP",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339136744",
            "telephone_number": "239-202-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17801 MURDOCK CIR UNIT C",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339484003",
            "telephone_number": "941-629-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 NE 2nd Pl Ste 106",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339092553",
            "country_code": "US",
            "telephone_number": "239-244-2917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN PEREDA",
        "first_name": "ZOE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.