| Axel Medical Group Llc | |
|
6811 Porto Fino Cir Fort Myers FL 33912-4354 | |
| (239) 208-6648 | |
| (855) 462-3008 |
| Full Name | Axel Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6811 Porto Fino Cir, Fort Myers, Florida |
| Authorized Official Name and Position | Jessell Llorente (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 2392238129 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Axel Medical Group Llc 4820 Griffin Blvd Fort Myers FL 33908-2016 Ph: (239) 208-6648 | Axel Medical Group Llc 6811 Porto Fino Cir Fort Myers FL 33912-4354 Ph: (239) 208-6648 |
| NPI Number | 1467140228 |
|---|---|
| Provider Enumeration Date | 04/28/2023 |
| Last Update Date | 09/19/2023 |
| Medicare PECOS PAC ID | 7517325525 |
|---|---|
| Medicare Enrollment ID | O20230623001377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467140228 | NPI | - | NPPES |
| Provider Name | Sumeet V Shetty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245319391 PECOS PAC ID: 8921067646 Enrollment ID: I20041007000639 |
| Provider Name | Shailaja Hegde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841281722 PECOS PAC ID: 3779548532 Enrollment ID: I20041122000548 |
| Provider Name | Rahul K Challapalli |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205815818 PECOS PAC ID: 4789721564 Enrollment ID: I20091027000848 |
| Provider Name | Catherine Mary Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427146315 PECOS PAC ID: 5395767636 Enrollment ID: I20110324000333 |
| Provider Name | Erin R Moffat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396293486 PECOS PAC ID: 1456631332 Enrollment ID: I20230405001108 |
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