FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. (NPI# 1295145191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295145191 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. |
| Practice Address |
4300 Kings Hwy Suite 210 Port Charlotte FL 33980-2917 |
| Mailing Address |
Po Box 919771 Orlando FL 32891-9771 |
| Practice Telephone | 2393442306 |
| Practice Fax Number | 9416292365 |
| Mailing Telephone | 2392783600 |
| Mailing Fax Number | 2392264650 |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2020-10-12 |
| Authorized Official Name | FRANK MAZZEO JR. (PRESIDENT/CEO) |
| Authorized Official Telephone | 2392783600 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 029570128 | 05 | |
| FL | BCBS | 99409 | 01 |
| FL | 029570127 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356853154 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 1926 Victoria Ave, Fort Myers, FL 33901-3414 | 2017-11-02 |
| 1871946368 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 10501 Fgcu Blvd S, Fort Myers, FL 33965-6502 | 2016-07-20 |
| 1417377813 | Family Health Centers of Southwest Florida, Inc. | Pharmacy | 316 Del Prado Blvd S, Cape Coral, FL 33990-1710 | 2014-04-24 |
| 1821412016 | Family Health Centers of Southwest Florida, Inc. | Pharmacy | 19701 S Tamiami Trl, Fort Myers, FL 33908-4818 | 2014-02-10 |
| 1366748402 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 3600 Broadway, Suite A, Fort Myers, FL 33901-8002 | 2011-02-08 |
| 1891005047 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 11921 Saradrienne Ln, Bonita Springs, FL 34135-5911 | 2010-10-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. | 2256 Heitman St, Fort Myers, FL 33901-3744 |
| Street Address |
4300 KINGS HWY SUITE 210 |
| City | PORT CHARLOTTE |
| State | FL |
| Zip Code | 33980-2917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760488464 | Ida Joann Gagliardi | Family Medicine | 4300 Kings Hwy, Suite 210, Port Charlotte, FL 33980-2917 | 2005-06-27 |
| 1700270394 | Sonya S Hasan | Dentist | 4300 Kings Hwy, #500, Port Charlotte, FL 33980-2917 | 2015-03-23 |
| 1053737049 | Jason Spears | Dentist | 4300 Kings Hwy, Suite 500, Port Charlotte, FL 33980-2917 | 2014-03-13 |
| 1083859326 | Sandra Hegarty | Pediatrics | 4300 Kings Hwy, #500, Port Charlotte, FL 33980-2917 | 2008-12-15 |
| 1962663211 | Family Health Centers of Southwest Florida Inc | Clinic/Center | 4300 Kings Hwy, Suite 500, Port Charlotte, FL 33980-2917 | 2008-06-19 |
| 1245333756 | John M Demarco | Dentist | 4300 Kings Hwy, #500, Port Charlotte, FL 33980-2917 | 2006-09-07 |
| 1366428633 | John R Lamanna Jr. | Pediatrics | 4300 Kings Hwy, Ste 500, Port Charlotte, FL 33980-2917 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144699646 | Raymond B Hendricks | Custodial Care Facility | 1306 Annette St, Port Charlotte, FL 33980 | 2015-09-15 |
| 1649616517 | Anne Yvonne Clarke | Nurse's Aide | 3378 Idlewild Street, Port Charlotte, FL 33980 | 2013-05-17 |
| 1427395680 | John F Guarino Md Pa | Surgery | 4245 Kings Hwy, Unit A, Port Charlotte, FL 33980 | 2013-01-08 |
| 1497049027 | Patricia Ann Drow | Occupational Therapist | 24469 Manchester Trail, Port Charlotte, FL 33980 | 2011-05-31 |
| 1811221484 | Amanda K Huffman | Clinical Nurse Specialist | 22655 Bayshore Rd Ste 130, Port Charlotte, FL 33980 | 2009-09-29 |
| 1093967739 | Donna Olson | Nurse Practitioner | 1100 Loveland Boulevard, Port Charlotte, FL 33980 | 2008-10-14 |
| 1821278029 | Paula Marie Allison | Dietitian, Registered | 23422 Burlingame Ave, Port Charlotte, FL 33980 | 2007-11-06 |
| 1689865891 | Keith Anthony Williams | Physical Medicine & Rehabilitation | 4265 Laura Street, Port Charlotte, FL 33980 | 2007-08-05 |
| 1578685491 | Richard Michael Cocchieri | Dentist | Florida Department of Health In Charlotte County, 1100 Loveland Boulevard, Port Charlotte, FL 33980 | 2007-04-03 |
| 1417989328 | John F Guarino | Surgery | 4245 Kings Highway, Unit A, Port Charlotte, FL 33980 | 2006-07-07 |
| Find all providers in zip 33980 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902425028 | Lee Memorial Health System | Clinic/Center | 2525 Harbor Blvd Ste 204, Port Charlotte, FL 33952-5342 | 2020-04-09 |
| 1164051405 | Lee Memorial Health System | Clinic/Center | 2484 Caring Way Unit F, Port Charlotte, FL 33952-5306 | 2020-04-08 |
| 1962663211 | Family Health Centers of Southwest Florida Inc | Clinic/Center | 4300 Kings Hwy, Suite 500, Port Charlotte, FL 33980-2917 | 2008-06-19 |
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| 1992316285 | Central Florida Health Care, Inc. | Clinic/Center | 225 Lincoln Ave, Lake Wales, FL 33853-3546 | 2020-08-11 |
| 1750919791 | City of Dunedin | Clinic/Center | 1042 Virginia St, Dunedin, FL 34698-7325 | 2020-03-27 |
| 1407481039 | Primary Care Medical Services of Poinciana Inc | Clinic/Center | 4303 Cameron Preserve Cir, Kissimmee, FL 34746-6304 | 2020-03-04 |
| 1669012498 | Project Health Inc | Clinic/Center | 595 N Lecanto Hwy, Lecanto, FL 34461-9187 | 2020-01-09 |
| 1477199289 | Community Health Centers, Inc. | Clinic/Center | 509 Cagan View Rd, Clermont, FL 34714-6405 | 2019-11-27 |
| 1396395075 | Citrus Health Network | Clinic/Center | 1645a Sw 107th Ave, Miami, FL 33165-7344 | 2019-09-16 |
| Find all providers with the same taxonomy | ||||
| City | PORT CHARLOTTE |
| Zip Code | 33980 |
Please comment or provide details below to improve the information on FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.