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ASSOCIATES IN NEPHROLOGY BUTCHER & DEVACAANTHAN MD PA NPI 1437100146


NPI Information

NPI: 1437100146
Provider Name: ASSOCIATES IN NEPHROLOGY BUTCHER & DEVACAANTHAN MD PA

Former Legal Business Name: ASSOCIATES IN NEPHROLOGY BUTCHER, CAANTHAN & DELANS MD PA

Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 10D2237847

Address:
7981 GLADIOLUS DR.
FORT MYERS, FL
ZIP 33908
Phone: (239) 939-0999
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ASSOCIATES IN NEPHROLOGY BUTCHER & DEVACAANTHAN MD PA is a specialist in Fort Myers, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ASSOCIATES IN NEPHROLOGY BUTCHER & DEVACAANTHAN MD PA NPI is 1437100146. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Associates In Nephrology Butcher, Caanthan & Delans Md Pa.

The provider's business location address is:

7981 GLADIOLUS DR.
FORT MYERS, FL
ZIP 33908-154
Phone: (239) 939-0999
Fax: (239) 939-1070

The provider's authorized official is Mary M Mouracade .
The authorized official title is Md and has the following contact phone number (239) 939-0999.

The CLIA number assigned to this NPI record is 10D2237847 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/15/2006 and was last updated on 11/11/2022.


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
1174400000XSpecialist4680129492717FLORIDAYes

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
1060544100MEDICAIDFLORIDA

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: 4/28/2024

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.