| Family Health Centers Of Southwest Florida, Inc. | |
|
4300 Kings Hwy Suite 210 Port Charlotte FL 33980-2917 | |
| (239) 344-2306 | |
| (941) 629-2365 |
| Full Name | Family Health Centers Of Southwest Florida, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4300 Kings Hwy, Port Charlotte, 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. 4300 Kings Hwy Suite 210 Port Charlotte FL 33980-2917 Ph: (239) 344-2306 |
| NPI Number | 1295145191 |
|---|---|
| Provider Enumeration Date | 04/30/2014 |
| Last Update Date | 05/18/2022 |
| Medicare PECOS PAC ID | 3173432085 |
|---|---|
| Medicare Enrollment ID | O20141021002199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295145191 | NPI | - | NPPES |
| 029570128 | Medicaid | FL | |
| 029570127 | Medicaid | FL | |
| 99409 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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