Healthcare Provider Details

I. General information

NPI: 1265170559
Provider Name (Legal Business Name): AMERICAN FAMILY CARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 NE 2ND PL STE 106
CAPE CORAL FL
33909-2553
US

IV. Provider business mailing address

110 NE 2ND PL STE 106
CAPE CORAL FL
33909-2553
US

V. Phone/Fax

Practice location:
  • Phone: 239-244-2917
  • Fax: 239-236-1991
Mailing address:
  • Phone: 239-244-2917
  • Fax: 239-236-1991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAILYS NUNEZ DIAZ
Title or Position: APRN
Credential: APRN
Phone: 239-244-2917