Organization
FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK MAZZEO JR. DDS (PRESIDENT/CEO)
(239) 278-3600
Entity
Organization
Contact information
Practice address
316 DEL PRADO BLVD S, CAPE CORAL, FL 33990-1710
(239) 314-1616
(239) 772-1613
Mailing address
PO BOX 919771, ORLANDO, FL 32891-9771
(239) 278-3600
(239) 278-3857
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
3336C0002X
Clinic Pharmacy
PH29774
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029570125
—
FL
05
—
029570126
—
FL
01
—
99409
BCBS
FL
Enumeration date
04/24/2014
Last updated
06/21/2022
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