Park Center for Procedures LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PARK CENTER FOR PROCEDURES LLC

Practice address

8255 College Pkwy Ste 100
Fort Myers, FL 33919-5119

Phone

(239) 267-2900

Fax

(239) 337-6866

NPI assigned

Apr 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan S Daitch, MDNPI 1215924154

Title

Physician

Phone

(239) 437-8000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Park Center for Procedures LLCCCN 10C0001534

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Practitioners 4

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

• Wladislaw G Fedoriw, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Seminole, FL
  • NPI 1477609899
  Medicare reassignment NPD
• Ryan Budwany, MD

  • Interventional Pain Medicine Physician
  • Lawrenceville, GA
  • NPI 1013302140

  FL

  Medicare reassignment NPD
• Jonathan S Daitch, MD

  • Pain Medicine Physician
  • Fort Myers, FL
  • NPI 1215924154
  NPD Authorized official
• Michael E Frey, MD

  • Interventional Pain Medicine Physician
  • Fort Myers, FL
  • NPI 1780672543
  NPD (past)

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1992970230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 07122",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339190122",
            "telephone_number": "239-267-2900",
            "fax_number": "239-337-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8255 COLLEGE PKWY STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195119",
            "telephone_number": "239-267-2900",
            "fax_number": "239-337-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK CENTER FOR PROCEDURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "DAITCH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "239-437-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priya Parekh, APRN
• Tanmay Parekh, M.D.
• Zachary George Parente, MD
• Mitchell Parham
• Richard S Paritzky, PHD
• Barbara Park, RBT (REGISTERED BT
• Sunmi Park
• Parker Family Medicine PLLC
• Dawne Louise Parker, FNP
• Edsel James Parker, A-APRN, FNP-C

• Ambulatory Surgical Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.