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PHYSICIANS PRIMARY CARE OF SOUTHWEST FLORIDA PL NPI 1083696033


NPI Information

NPI: 1083696033
Provider Name: PHYSICIANS PRIMARY CARE OF SOUTHWEST FLORIDA, PL
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 10D0293482

Address:
9350 CAMELOT DR
FORT MYERS, FL
ZIP 33919
Phone: (239) 481-5437
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PHYSICIANS PRIMARY CARE OF SOUTHWEST FLORIDA, PL is a pediatrics in Fort Myers, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. PHYSICIANS PRIMARY CARE OF SOUTHWEST FLORIDA, PL NPI is 1083696033. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9350 CAMELOT DR
FORT MYERS, FL
ZIP 33919-980
Phone: (239) 481-5437
Fax: (239) 481-0570

The provider's authorized official is Mary C. Yankaskas .
The authorized official title is Managing Physician and has the following contact phone number (239) 275-5522.

The CLIA number assigned to this NPI record is 10D0293482 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/16/2005 and was last updated on 8/25/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerNo
2208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1379245506MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.