| Cape Doc | |
|
290 Nicholas Parkway Nw Suite 1 Cape Coral FL 33991-3804 | |
| (239) 573-1152 | |
| (239) 573-1360 |
| Full Name | Cape Doc |
|---|---|
| Speciality | Family Medicine |
| Location | 290 Nicholas Parkway Nw, Cape Coral, Florida |
| Authorized Official Name and Position | Johanna C Alvarez (OWNER) |
| Authorized Official Contact | 2399948615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cape Doc 290 Nicholas Pkwy Nw Ste 1 Cape Coral FL 33991-3804 Ph: (239) 573-1152 | Cape Doc 290 Nicholas Parkway Nw Suite 1 Cape Coral FL 33991-3804 Ph: (239) 573-1152 |
| NPI Number | 1396217865 |
|---|---|
| Provider Enumeration Date | 12/21/2018 |
| Last Update Date | 05/23/2024 |
| Medicare PECOS PAC ID | 2365780368 |
|---|---|
| Medicare Enrollment ID | O20190218001968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396217865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207RH0005X | Internal Medicine - Hypertension Specialist | (* (Not Available)) | Secondary |
| Provider Name | Edwin Kyung Chung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104841360 PECOS PAC ID: 2163336520 Enrollment ID: I20150924000475 |
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