MEDICARE: SW FLORIDA MEDICAL GROUP LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	207Q00000X	Family Medicine Physician
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558969139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SW FLORIDA MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	3637 DEL PRADO BLVD S STE 101
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-7199
Country	:	US
Telephone Number	:	239-269-8767
Fax Number	:

Provider Business Practice Location Address
First Line	:	3637 DEL PRADO BLVD S STE 101
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-7199
Country	:	US
Telephone Number	:	239-269-8767
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TOMAS TOLEDO
Credential	:
Telephone Number	:	239-269-8767

Provider Enumeration Date	:	10/15/2020
Last Update Date	:	01/20/2026

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Directions to “SW FLORIDA MEDICAL GROUP LLC ” Practice Location

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