| Family Health Centers Of Southwest Florida, Inc. | |
|
4300 Kings Hwy Ste 210 Port Charlotte FL 33980-2922 | |
| (239) 344-2306 | |
| (941) 629-2365 |
| Full Name | Family Health Centers Of Southwest Florida, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4300 Kings Hwy Ste 210, Port Charlotte, Florida |
| Authorized Official Name and Position | Frank Mazzeo (PRESIDENT/CEO) |
| Authorized Official Contact | 2392783600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Centers Of Southwest Florida, Inc. Po Box 919771 Orlando FL 32891-0001 Ph: (239) 278-3600 | Family Health Centers Of Southwest Florida, Inc. 4300 Kings Hwy Ste 210 Port Charlotte FL 33980-2922 Ph: (239) 344-2306 |
| NPI Number | 1114698701 |
|---|---|
| Provider Enumeration Date | 09/23/2021 |
| Last Update Date | 05/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114698701 | NPI | - | NPPES |
| 029570128 | Medicaid | FL | |
| 101180 | Other | FL | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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