| Physicians Medical Group Of Southwest Florida,llc | |
|
3800 Colonial Blvd Ste 200 Fort Myers FL 33966-1075 | |
| (239) 936-1233 | |
| (239) 936-8576 |
| Full Name | Physicians Medical Group Of Southwest Florida,llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3800 Colonial Blvd Ste 200, Fort Myers, Florida |
| Authorized Official Name and Position | Barry K Butler (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2399361233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physicians Medical Group Of Southwest Florida,llc 3800 Colonial Blvd Ste 200 Fort Myers FL 33966-1075 Ph: (239) 936-1233 | Physicians Medical Group Of Southwest Florida,llc 3800 Colonial Blvd Ste 200 Fort Myers FL 33966-1075 Ph: (239) 936-1233 |
| NPI Number | 1104259035 |
|---|---|
| Provider Enumeration Date | 08/14/2013 |
| Last Update Date | 06/19/2023 |
| Medicare PECOS PAC ID | 2264669738 |
|---|---|
| Medicare Enrollment ID | O20131210000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104259035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS002373 (Florida) | Primary |
| Provider Name | Barry K Butler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770581449 PECOS PAC ID: 9830134402 Enrollment ID: I20080913000085 |
| Provider Name | Aaron J Fralicker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427597244 PECOS PAC ID: 1355776253 Enrollment ID: I20200123001500 |
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