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
930 S MAIN ST, LABELLE, FL 33935-4448
(863) 675-0160
(863) 675-1346
Mailing address
PO BOX 919771, ORLANDO, FL 32891-0001
(239) 278-3600
(239) 479-5122
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029570138
—
FL
01
—
101885
MEDICARE
FL
Enumeration date
09/17/2021
Last updated
06/21/2022
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