| Gulfcoast Md Pa | |
|
13440 Parker Commons Blvd Ste 105 Fort Myers FL 33912-1816 | |
| (239) 225-6304 | |
| Not Available |
| Full Name | Gulfcoast Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 13440 Parker Commons Blvd Ste 105, Fort Myers, Florida |
| Authorized Official Name and Position | Melwyn Salvadore Dsouza (CEO) |
| Authorized Official Contact | 2392655586 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulfcoast Md Pa 13440 Parker Commons Blvd Ste 105 Fort Myers FL 33912-1816 Ph: (239) 225-6304 | Gulfcoast Md Pa 13440 Parker Commons Blvd Ste 105 Fort Myers FL 33912-1816 Ph: (239) 225-6304 |
| NPI Number | 1528233962 |
|---|---|
| Provider Enumeration Date | 04/27/2008 |
| Last Update Date | 04/21/2020 |
| Medicare PECOS PAC ID | 8527132661 |
|---|---|
| Medicare Enrollment ID | O20080807000179 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528233962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME89047 (Florida) | Primary |
| Provider Name | Raynita C D Souza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467468579 PECOS PAC ID: 3274506225 Enrollment ID: I20040817001105 |
| Provider Name | Melwyn Dsouza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972519924 PECOS PAC ID: 4385617109 Enrollment ID: I20040818001049 |
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