| Southwest General Healthcare Center Corp | |
|
29 Barkley Cir Fort Myers FL 33907-7531 | |
| (239) 931-3366 | |
| (239) 931-1262 |
| Full Name | Southwest General Healthcare Center Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 29 Barkley Cir, Fort Myers, Florida |
| Authorized Official Name and Position | Yoel A Santana (OWNER, PRESIDENT) |
| Authorized Official Contact | 2397190157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest General Healthcare Center Corp 29 Barkley Cir Fort Myers FL 33907-7531 Ph: (239) 931-3366 | Southwest General Healthcare Center Corp 29 Barkley Cir Fort Myers FL 33907-7531 Ph: (239) 931-3366 |
| NPI Number | 1487030870 |
|---|---|
| Provider Enumeration Date | 08/07/2015 |
| Last Update Date | 07/14/2020 |
| Medicare PECOS PAC ID | 8325345267 |
|---|---|
| Medicare Enrollment ID | O20160321002074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487030870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | EXEMPT (Florida) | Primary |
| Provider Name | Paige Kreegel |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1891735742 PECOS PAC ID: 5597718627 Enrollment ID: I20050301000225 |
| Provider Name | Manuel Diaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295014348 PECOS PAC ID: 3678792967 Enrollment ID: I20140918001658 |
| Provider Name | Jose E Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548506553 PECOS PAC ID: 9234438961 Enrollment ID: I20160502002404 |
| Provider Name | Rene Coto Borges |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1821407826 PECOS PAC ID: 2163707399 Enrollment ID: I20170330000252 |
| Provider Name | Juan A Carmona |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1083153761 PECOS PAC ID: 7113189671 Enrollment ID: I20171226000334 |
| Provider Name | Fernando Jesus Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639534100 PECOS PAC ID: 9335482181 Enrollment ID: I20200319002428 |
| Provider Name | Zenia Garcia Padron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649806423 PECOS PAC ID: 2769808476 Enrollment ID: I20200812001572 |
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