SOUTHWEST FLORIDA FERTILITY CENTER PA (NPI# 1588749618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588749618 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST FLORIDA FERTILITY CENTER PA |
| Practice Address |
15730 New Hampshire Ct Suite 101 Fort Myers FL 33908 |
| Practice Telephone | 2395613430 |
| Practice Fax Number | 2395616980 |
| Mailing Telephone | 2395613430 |
| Mailing Fax Number | 2395616980 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2009-01-12 |
| Authorized Official Name | MR. JACOB LEON GLOCK (PRESIDENT) |
| Authorized Official Telephone | 2395613430 |
| Authorized Official Credential | MEDICAL DOCTOR M |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
ME0057264 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FLORIDA STATE LICENSE | ME0057264 | 01 |
| FL | 379285400 | 05 |
| Street Address |
15730 NEW HAMPSHIRE CT SUITE 101 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386943694 | Jacob Leon Glock | Specialist | 15730 New Hampshire Ct, Unit 101, Fort Myers, FL 33908-4121 | 2011-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081806 | 1 Recovery | Community/Behavioral Health | 111 Daniels Dr, Fort Myers, FL 33908 | 2020-10-20 |
| 1457916462 | Avipharm, LLC | Pharmacy | 7669 Calistoble Loop, 2nd Floor, Fort Myers, FL 33908 | 2019-05-06 |
| 1013492289 | Craig M Stein | Pharmacist | 15236 Tropic Bird Court, Fort Myers, FL 33908 | 2018-10-03 |
| 1730665167 | Kyndra Lynn Petrick | Psychiatry & Neurology | 8560 Big Mangrove Dr, Fort Myers, FL 33908 | 2018-07-18 |
| 1447757547 | Douglas L Jarrett | Nurse Practitioner | 16261 Bass Rd Suite 300, Fort Myers, FL 33908 | 2018-04-06 |
| 1447754825 | Luis Daniel Ramos | General Practice | 15590 Ocean Walk Cir Apt 201, Fort Myers, FL 33908 | 2018-03-21 |
| 1619497062 | Vanesa Paola Vaquer | Dentist | 18070 S Tamiami Trl Ste 101, Fort Myers, FL 33908 | 2017-06-26 |
| 1962859603 | Teresa Ruiz | Behavior Technician | 15081 Woodrich Bend Ct Apt 416, Fort Myers, FL 33908 | 2016-05-23 |
| 1669865721 | Elena B. Alexiev | Dentist | 18070 S. Tamiami Trail, #101, Fort Myers, FL 33908 | 2015-03-13 |
| 1134488919 | Cecelia Anne Collins | Dietitian, Registered | 9215 Calle Arragon Avenue, Unit 205, Fort Myers, FL 33908 | 2012-05-14 |
| Find all providers in zip 33908 | ||||
| Taxonomy Code | 207VE0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Reproductive Endocrinology |
| An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790891653 | Craig Richard Sweet | Obstetrics & Gynecology | 12611 World Plaza Ln, Building 53, Fort Myers, FL 33907-3990 | 2006-08-22 |
| 1144887274 | Embryo Donation International | Obstetrics & Gynecology | 12611 World Plaza Ln Bldg 53, Fort Myers, FL 33907-3990 | 2019-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013410497 | Sgf Tampa Bay LLC | Obstetrics & Gynecology | 5016 West Cypress Street, Suite 301, Tampa, FL 33609-3804 | 2018-03-13 |
| 1295126779 | Mark S. Denker M.d. Pa Inc. | Obstetrics & Gynecology | 7015 Beracasa Way Ste 201, Ste # 201, Boca Raton, FL 33433-3453 | 2015-02-05 |
| 1144644634 | Moshe R. Peress | Obstetrics & Gynecology | 875 Meadows Rd Ste 334, Boca Raton, FL 33486-2349 | 2014-02-05 |
| 1114244803 | Juan Pablo Alvarez | Obstetrics & Gynecology | 4425 Ponce De Leon Blvd Ste 110, Coral Gables, FL 33146-1842 | 2010-04-21 |
| 1003059825 | George Patounakis | Obstetrics & Gynecology | 400 Colonial Center Pkwy, Suite 150, Lake Mary, FL 32746-7682 | 2009-04-08 |
| 1104004688 | Fernando L Gomez Md Pa | Obstetrics & Gynecology | 258 South Chickasaw Trail, Suite 310, Orlando, FL 32825-8232 | 2008-02-06 |
| 1578764742 | Martin Mark Quigley | Obstetrics & Gynecology | 1056 Paseo Del Rio Ne, Saint Petersburg, FL 33702-1457 | 2007-05-29 |
| 1386851350 | Anthony Nosa Imudia | Obstetrics & Gynecology | 2324 Cypress Cv, Wesley Chapel, FL 33544-6787 | 2007-05-17 |
| 1497848626 | Milton Mcnichol | Obstetrics & Gynecology | 1000 N Maitland Ave, Maitland, FL 32751-8406 | 2006-10-02 |
| 1255438636 | Melinda B Henne | Obstetrics & Gynecology | 14540 Old Saint Augustine Rd Ste 2503, Jacksonville, FL 32258 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | FORT MYERS |
| Zip Code | 33908 |
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| 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.