|
| |
|
13880 Shell Point Plaza Suite 110 Fort Myers FL 33908 | |
| (239) 466-1111 | |
| (239) 454-2111 |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 13880 Shell Point Plaza, Fort Myers, Florida |
| Authorized Official Name and Position | Tasha Marie Vassar (MEDICAL BILLING MANAGER) |
| Authorized Official Contact | 2394337937 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
13880 Shell Point Plaza Suite 110 Fort Myers FL 33908-3504 Ph: (239) 454-2146 | 13880 Shell Point Plaza Suite 110 Fort Myers FL 33908 Ph: (239) 466-1111 |
| NPI Number | 1821160607 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 02/14/2022 |
| Certification Date | 02/02/2022 |
| Medicare PECOS PAC ID | 9739072232 |
|---|---|
| Medicare Enrollment ID | O20040207000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821160607 | NPI | - | NPPES |
| Provider Name | Nancy T Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073605747 PECOS PAC ID: 1355234857 Enrollment ID: I20040207000020 |
| Provider Name | James Joseph Omailia |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275530099 PECOS PAC ID: 1153302955 Enrollment ID: I20040527000568 |
| Provider Name | Michele A Candelore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720146566 PECOS PAC ID: 4183712375 Enrollment ID: I20071126000212 |
| Provider Name | Kathy A Fratrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275605909 PECOS PAC ID: 2466519301 Enrollment ID: I20090320000496 |
| Provider Name | Amy Jo Dudley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851604813 PECOS PAC ID: 3072705474 Enrollment ID: I20101004000905 |
| Provider Name | David William Nesselroade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679646251 PECOS PAC ID: 0840482832 Enrollment ID: I20101008000616 |
| Provider Name | Maria F Badami |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164458949 PECOS PAC ID: 3577693951 Enrollment ID: I20110603000316 |
| Provider Name | Gary Goforth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902823925 PECOS PAC ID: 9931238490 Enrollment ID: I20120828000088 |
| Provider Name | Lewis T Caldrone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033534003 PECOS PAC ID: 6002030335 Enrollment ID: I20140606001167 |
| Provider Name | Sarah Mcgregor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164823043 PECOS PAC ID: 7214157338 Enrollment ID: I20141013000505 |
| Provider Name | Rocio Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699201194 PECOS PAC ID: 4587933916 Enrollment ID: I20170628001941 |
| Provider Name | Miguel Angel Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962928994 PECOS PAC ID: 3274808084 Enrollment ID: I20171004002285 |
| Provider Name | Kathy Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366837049 PECOS PAC ID: 9739495961 Enrollment ID: I20190716000561 |
| Provider Name | Shane Thomas Geffe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568091197 PECOS PAC ID: 2668870379 Enrollment ID: I20211011002690 |
| Provider Name | Letoya Christian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154082139 PECOS PAC ID: 2365835618 Enrollment ID: I20220208003010 |
| Provider Name | Robert William Fung |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912392812 PECOS PAC ID: 0143536409 Enrollment ID: I20230309000852 |
| Provider Name | Holly Orlasky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407300288 PECOS PAC ID: 1052777208 Enrollment ID: I20230515001439 |
| Provider Name | Nicole Y Jimenez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497334171 PECOS PAC ID: 9133577489 Enrollment ID: I20231127001808 |
| Provider Name | Alyssa Cella Coates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518166958 PECOS PAC ID: 8426499252 Enrollment ID: I20240514000582 |
| Provider Name | Scott C Scoggins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699771014 PECOS PAC ID: 4284788175 Enrollment ID: I20240821001939 |
| Provider Name | Fahimy Saoud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720861008 PECOS PAC ID: 1951840750 Enrollment ID: I20240824000058 |
D J Koehn Consulting Services Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 8359 Beacon Blvd Ste 301, Fort Myers, FL 33907 Phone: 571-309-7993 Fax: 800-387-5701 | |
Hope Community Wellness Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6238 Presidential Ct # Crt 7/8, Fort Myers, FL 33919 Phone: 863-233-9190 | |
Health Planning Council Of Southwest Florida, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8961 Daniels Center Dr Ste 401, Fort Myers, FL 33912 Phone: 239-433-6700 | |
Nest Academy & Therapy Center Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4755 Summerlin Rd Ste 4, Fort Myers, FL 33919 Phone: 786-382-5779 | |
Gables Rehab Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3049 Cleveland Ave Ste 145, Fort Myers, FL 33901 Phone: 786-641-1312 |