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Organization

FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FRANK S MAZZEO JR. (PRESIDENT CEO)
(239) 278-3600
Entity
Organization

Contact information

Practice address
2232 GRAND AVE, FORT MYERS, FL 33901-3717
(239) 344-2330
(239) 332-4701
Mailing address
PO BOX 919771, ORLANDO, FL 32891-9771
(239) 278-3600
(239) 226-4650

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
PH7923
FL
3336C0002X
Clinic Pharmacy
PH7923
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
029570100
FL
05
056887200
FL
Enumeration date
05/17/2006
Last updated
05/18/2022
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