| Family Health Centers Of Southwest Florida, Inc. | |
|
19701 S Tamiami Trl Fort Myers FL 33908-4818 | |
| (239) 314-1600 | |
| (239) 425-6402 |
| Full Name | Family Health Centers Of Southwest Florida, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 19701 S Tamiami Trl, Fort Myers, 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. 19701 S Tamiami Trl Fort Myers FL 33908-4818 Ph: (239) 314-1600 |
| NPI Number | 1821412016 |
|---|---|
| Provider Enumeration Date | 02/10/2014 |
| Last Update Date | 05/18/2022 |
| Medicare PECOS PAC ID | 3173432085 |
|---|---|
| Medicare Enrollment ID | O20140722002084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821412016 | NPI | - | NPPES |
| 029570124 | Medicaid | FL | |
| 029570117 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 3336C0002X | Pharmacy - Clinic Pharmacy | PH28479 (Florida) | Secondary |
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Lch-internal Medicine Matthew Drive Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1569 Matthew Dr, Fort Myers, FL 33907 Phone: 239-343-8220 Fax: 239-468-7909 | |
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