NPIMap

Organization Active NPI

Maternal Fetal Medicine of S.W. FL

  • Maternal & Fetal Medicine Physician
  • Port Charlotte, FL
National Provider Identifier
1962701672
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
MATERNAL FETAL MEDICINE OF S.W. FL
Practice address
2400 Harbor Blvd
Unit 7
Port Charlotte, FL 33952-5038
Phone
(941) 391-8010
Fax
(941) 391-8013
NPI assigned
Mar 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Authorized official

Name
Marty Menna
Title
Executive Assistant
Phone
(239) 333-3826

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VM0101X Primary

Addresses

Primary practice location

2400 Harbor Blvd
Unit 7
Port Charlotte, FL 33952-5038

Mailing address

8270 College Pkwy
Suite 205
Fort Myers, FL 33919
Phone (239) 333-3826

National Provider Directory

National Provider Directory
Tax ID family
Maternal Fetal Medicine of SW FL4 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.

NPI Registry JSON

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1962701672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8270 COLLEGE PKWY",
            "address_2": "SUITE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33919",
            "telephone_number": "239-333-3826",
            "fax_number": "239-333-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HARBOR BLVD",
            "address_2": "UNIT 7",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525038",
            "telephone_number": "941-391-8010",
            "fax_number": "941-391-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATERNAL FETAL MEDICINE OF S.W. FL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "MENNA",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "239-333-3826"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.