Organization Active NPI

Del Prado Medical Center Inc

  • General Practice Physician
  • Cape Coral, FL
National Provider Identifier
1982855359
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
DEL PRADO MEDICAL CENTER INC
Practice address
2500 Del Prado Blvd S
Cape Coral, FL 33904-5750
Phone
(239) 772-1194
Fax
(239) 772-1196
NPI assigned
Oct 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Daisy Martinez
Title
Owner/President
Phone
(239) 772-1194

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

2500 Del Prado Blvd S
Cape Coral, FL 33904-5750

Mailing address

2500 Del Prado Blvd S
Cape Coral, FL 33904-5750
Phone (239) 772-1194

Other practice location 1

5612 8th St W Unit 1
Lehigh Acres, FL 33971-6320
Phone (239) 772-1194

Other identifiers 3

IdentifierTypeStateIssuer
BD041OtherFLMEDICARE
022008300MedicaidFL
022008301MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090105000294 FL Part B Supplier - Clinic/Group Practice 7618039496 Receives reassigned benefits from 8 practitioners
Practice locations: Cape Coral, FL; Lehigh Acres, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2298056Del Prado Medical Center Inc5612 8TH St W Suite 1, Lehigh Acres, FL 33971Certificate of waiverJan 25, 2028

National Provider Directory

National Provider Directory

Locations

2500 Del Prado Blvd S
Cape Coral, FL 33904
Phone (239) 541-1095

5612 8th St W
Ste 12
Lehigh Acres, FL 33971
Phone (239) 772-1194

5612 8th St W
Unit 1
Lehigh Acres, FL 33971
Phone (239) 772-1194

Interoperability endpoints

  • FHIR API: https://fhir.healthtogo.me/fhir/r4/mdvita.dpmc

Practitioners & affiliated clinicians

Practitioners 8

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": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1982855359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339045750",
            "telephone_number": "239-772-1194",
            "fax_number": "239-772-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339045750",
            "telephone_number": "239-772-1194",
            "fax_number": "239-772-1196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5612 8th St W Unit 1",
            "address_purpose": "LOCATION",
            "city": "Lehigh Acres",
            "state": "FL",
            "postal_code": "339716320",
            "country_code": "US",
            "telephone_number": "239-772-1194",
            "fax_number": "239-772-1196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DEL PRADO MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "DAISY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "239-772-1194"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "BD041",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022008300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022008301",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.