| Constante Family Practice | |
|
12400 Brantley Commons Ct Suite 1 Fort Myers FL 33907-5663 | |
| (239) 275-9040 | |
| (239) 275-9070 |
| Full Name | Constante Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 12400 Brantley Commons Ct, Fort Myers, Florida |
| Authorized Official Name and Position | Galo F Constante (OWNER) |
| Authorized Official Contact | 2392759040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Constante Family Practice Po Box 60533 Fort Myers FL 33906-6533 Ph: (239) 275-9040 | Constante Family Practice 12400 Brantley Commons Ct Suite 1 Fort Myers FL 33907-5663 Ph: (239) 275-9040 |
| NPI Number | 1437316890 |
|---|---|
| Provider Enumeration Date | 05/21/2008 |
| Last Update Date | 07/02/2010 |
| Medicare PECOS PAC ID | 6608924618 |
|---|---|
| Medicare Enrollment ID | O20090501000057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437316890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | P03000075881 (Florida) | Primary |
| Provider Name | Kelly B Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073631651 PECOS PAC ID: 2466537626 Enrollment ID: I20080312000087 |
| Provider Name | Galo Constante |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790768463 PECOS PAC ID: 7618025628 Enrollment ID: I20090501000044 |
| Provider Name | Damaris Espinosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306436308 PECOS PAC ID: 3678981123 Enrollment ID: I20210421002027 |
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