Unknown Individual – Nurse Practitioner, NPI 1013361369
Nurse Practitioner
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
2450, Tamiami Trail, Port Charlotte, Charlotte County, Florida, 33952, United States
SUITE A
PORT CHARLOTTE, FL 339523922
Phone: (941) 624-2704
Fax: (941) 627-6066
Type: Location
3434, Hancock Bridge Parkway, Marina Town Condo Apartments, North Fort Myers, Lee County, Florida, 33903, United States
SUITE 301
NORTH FORT MYERS, FL 339037094
Phone: (877) 856-3774
Fax: (239) 599-2612
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33952)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | FL | |
| Nurse Practitioner | FL | |
| Family Practice | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Cardiovascular Disease (Cardiology), Internal Medicine | FL | |
| Nurse Practitioner | FL |
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