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
19701 S TAMIAMI TRL, FORT MYERS, FL 33908-4818
(239) 314-1600
(239) 425-6402
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
—
—
3336C0002X
Clinic Pharmacy
PH28479
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029570117
—
FL
05
—
029570124
—
FL
Enumeration date
02/10/2014
Last updated
05/18/2022
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