Individual provider Active NPI

Juan A Damiani, MD

  • Anesthesiology Physician
  • Ft Myers, FL
National Provider Identifier
1962491993
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME0077195 Issued in FL
Practice address
4048 Evans Ave
Suite 303
Ft Myers, FL 33901-9322
Phone
(239) 332-5344
Fax
(239) 332-7246
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME0077195 FL Primary

Addresses

Primary practice location

4048 Evans Ave
Suite 303
Ft Myers, FL 33901-9322

Mailing address

4048 Evans Ave
Suite 303
Ft Myers, FL 33901-9322
Phone (239) 332-5344

Other identifiers 5

IdentifierTypeStateIssuer
0867335OtherFLCIGNA
2613909OtherFLAETNA
258083700MedicaidFL
050070534OtherFLMCR RR
44703OtherFLBSFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78938MAMDRegistered Nurse
ME0077195FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
US Anesthesia Partners of Florida Inc. Anesthesiology CurrentSince Mar 25, 2015 Accepting new patients
Jennifer Sassi PA PastSince Feb 5, 2014 Accepting new patients

Locations

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1962491993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 EVANS AVE",
            "address_2": "SUITE 303",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339019322",
            "telephone_number": "239-332-5344",
            "fax_number": "239-332-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 EVANS AVE",
            "address_2": "SUITE 303",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339019322",
            "telephone_number": "239-332-5344",
            "fax_number": "239-332-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIANI",
        "first_name": "JUAN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME0077195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0867335",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2613909",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258083700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR RR",
            "identifier": "050070534",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSFL",
            "identifier": "44703",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Myers, FL

Sources for this page

Verify at the official NPI Registry.