Organization Active NPI

Dr. Fereshteh Nourafshar M.D.

  • Pediatrics Physician
  • Fort Myers, FL
National Provider Identifier
1972906261
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME76450 Issued in FL
Legal business name
DR. FERESHTEH NOURAFSHAR M.D.
Practice address
4575 Via Royale
Suite 216
Fort Myers, FL 33919-1043
Phone
(239) 277-9009
Fax
(239) 277-9007
NPI assigned
Oct 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Authorized official

Name
Fereshteh Nourafshar, M.D.NPI 1932152444
Title
Owner
Phone
(239) 949-9992

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME76450 FL Primary

Addresses

Primary practice location

4575 Via Royale
Suite 216
Fort Myers, FL 33919-1043

Mailing address

9200 Bonita Beach Rd SE
Suite 106
Bonita Springs, FL 34135-4280
Phone (239) 949-9992

Other identifiers 1

IdentifierTypeStateIssuer
260538400MedicaidFL

National Provider Directory

National Provider Directory

Locations

9200 Bonita Beach Rd SE
Ste 106
Bonita Springs, FL 34135
Phone (239) 213-0690

4575 Via Royale
Ste 216
Fort Myers, FL 33919
Phone (239) 277-9009

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1972906261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 BONITA BEACH RD SE",
            "address_2": "SUITE 106",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354280",
            "telephone_number": "239-949-9992",
            "fax_number": "239-949-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 VIA ROYALE",
            "address_2": "SUITE 216",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191043",
            "telephone_number": "239-277-9009",
            "fax_number": "239-277-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. FERESHTEH NOURAFSHAR M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "NOURAFSHAR",
        "authorized_official_first_name": "FERESHTEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-949-9992",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME76450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260538400",
            "state": "FL"
        }
    ],
    "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 Oct 1, 2014; 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.