| Family Health Centers Of Southwest Florida, Inc. | |
|
11921 Saradrienne Ln Bonita Springs FL 34135-5911 | |
| (239) 344-2331 | |
| (239) 949-1593 |
| Full Name | Family Health Centers Of Southwest Florida, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 11921 Saradrienne Ln, Bonita Springs, Florida |
| Authorized Official Name and Position | Frank Mazzeo (PRESIDENT/ CEO) |
| Authorized Official Contact | 2392783600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Centers Of Southwest Florida, Inc. Po Box 919771 Orlando FL 32891-9771 Ph: (239) 278-3600 | Family Health Centers Of Southwest Florida, Inc. 11921 Saradrienne Ln Bonita Springs FL 34135-5911 Ph: (239) 344-2331 |
| NPI Number | 1891005047 |
|---|---|
| Provider Enumeration Date | 10/20/2010 |
| Last Update Date | 06/21/2022 |
| Medicare PECOS PAC ID | 3173432085 |
|---|---|
| Medicare Enrollment ID | O20140722002462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891005047 | NPI | - | NPPES |
| 029570106 | Medicaid | FL | |
| 99409 | Other | BLUE CROSS BLUE SHIELD | |
| 056887205 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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