NPIMap

Organization Active NPI

Azul Cosmetic Surgery & Medical Spa PA

  • Ophthalmology Physician
  • Fort Myers, FL
National Provider Identifier
1952335945
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME63087 Issued in FL
Legal business name
AZUL COSMETIC SURGERY & MEDICAL SPA PA
Practice address
13470 Parker Commons Blvd
Suite 101
Fort Myers, FL 33912-1809
Phone
(239) 415-7576
NPI assigned
Jul 10, 2006
Last updated
Jul 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Patrick Flaharty, MDNPI 1801975412
Title
Owner
Phone
(239) 415-7576

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME63087 FL Primary
Plastic Surgery Physician 208200000X ME63087 FL

Addresses

Primary practice location

13470 Parker Commons Blvd
Suite 101
Fort Myers, FL 33912-1809

Mailing address

PO Box 07339
Fort Myers, FL 33919-0339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080701000431 FL Part B Supplier - Clinic/Group Practice 9830261106 Receives reassigned benefits from 5 practitioners
Practice locations: Estero, FL; Naples, FL; Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

23451 Walden Center Dr
Ste 400
Estero, FL 34134
Phone (239) 415-7576

13470 Parker Commons Blvd
Fort Myers, FL 33912

13470 Parker Commons Blvd
Ste 10
Fort Myers, FL 33912

13470 Parker Commons Blvd
Ste 101
Fort Myers, FL 33912
Phone (239) 379-8925

1009 Crosspointe Dr
Ste 1
Naples, FL 34110
Phone (239) 415-7576

Practitioners & affiliated clinicians

Practitioners 10

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": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1952335945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 07339",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339190339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13470 PARKER COMMONS BLVD",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121809",
            "telephone_number": "239-415-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZUL COSMETIC SURGERY & MEDICAL SPA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "FLAHARTY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-415-7576",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME63087",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME63087",
            "primary": false
        }
    ],
    "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 Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.