NPIMap

Organization Active NPI

Florida Neurology Group P L

  • Neurology Physician
  • Fort Myers, FL
National Provider Identifier
1962497669
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
FLORIDA NEUROLOGY GROUP P L
Practice address
12670 Whitehall Dr
Fort Myers, FL 33907-3619
Phone
(239) 936-3554
Fax
(239) 936-8993
NPI assigned
Sep 19, 2005
Last updated
Aug 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Authorized official

Name
Mrs. Debbie A King
Title
Business Mananger
Phone
(239) 936-3554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

12670 Whitehall Dr
Fort Myers, FL 33907-3619

Mailing address

12670 Whitehall Dr
Fort Myers, FL 33907-3619
Phone (239) 936-3554

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050720000536 FL Part B Supplier - Clinic/Group Practice 0840286407 Receives reassigned benefits from 30 practitioners
Practice locations: Cape Coral, FL; Fort Myers, FL

National Provider Directory

National Provider Directory
Tax ID family
Florida Neurology Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1003 Del Prado Blvd S
Ste 202
Cape Coral, FL 33990
Phone (239) 574-4242

12670 Whitehall Dr
Fort Myers, FL 33907
Phone (239) 936-3554

63 Barkley Cir
Ste 101
Fort Myers, FL 33907
Phone (239) 245-7908

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408924800000",
    "number": "1962497669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12670 WHITEHALL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073619",
            "telephone_number": "239-936-3554",
            "fax_number": "239-936-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12670 WHITEHALL DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073619",
            "telephone_number": "239-936-3554",
            "fax_number": "239-936-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA NEUROLOGY GROUP P L",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2014-08-25",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANANGER",
        "authorized_official_telephone_number": "239-936-3554",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "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 Aug 25, 2014; 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.