Organization
FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK MAZZEO JR. D.D.S. (PRESIDENT/CEO)
(239) 278-3600
Entity
Organization
Contact information
Practice address
11100 SUMMER RIDGE LANE, FORT MYERS, FL 33908-0000
(239) 344-2389
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029570108
—
FL
05
—
029570109
—
FL
01
—
99409
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/29/2010
Last updated
06/21/2022
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