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11621 S Cleveland Ave Ste 50 Fort Myers FL 33907-2866 | |
(239) 533-9903 | |
(239) 307-6110 |
Full Name | |
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Speciality | Clinic/Center |
Location | 11621 S Cleveland Ave Ste 50, Fort Myers, Florida |
Authorized Official Name and Position | Andres Zapata (OWNER/ADMIN) |
Authorized Official Contact | 3052445883 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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12277 Sw 130th St Miami FL 33186-6218 Ph: (305) 470-9399 | 11621 S Cleveland Ave Ste 50 Fort Myers FL 33907-2866 Ph: (239) 533-9903 |
NPI Number | 1215625447 |
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Provider Enumeration Date | 04/26/2023 |
Last Update Date | 03/13/2024 |
Medicare PECOS PAC ID | 7911348040 |
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Medicare Enrollment ID | O20240507003264 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215625447 | NPI | - | NPPES |
OT11471 | Other | FL | MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Andres F Zapata |
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Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1750328316 PECOS PAC ID: 1759357726 Enrollment ID: I20040909001378 |
Provider Name | Palmer Reap |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1033678560 PECOS PAC ID: 8921348269 Enrollment ID: I20190322001095 |
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