MEDICARE: INFINITY HEALTHCARE EAST FT. MYERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1245948603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITY HEALTHCARE EAST FT. MYERS LLC

Provider Business Mailing Address
First Line	:	2730 N STATE ROAD 7
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5726
Country	:	US
Telephone Number	:	954-586-8058
Fax Number	:	754-222-6417

Provider Business Practice Location Address
First Line	:	11390 PALM BEACH BLVD STE 301B
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-5921
Country	:	US
Telephone Number	:	239-237-2133
Fax Number	:	754-222-6417

Authorized Official
Title or Position	:	CEO
Name	:	JOSEPH DI CAPUA
Credential	:
Telephone Number	:	561-843-7720

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	09/03/2025

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