Healthcare Provider Details

I. General information

NPI: 1639091515
Provider Name (Legal Business Name): PINEAPPLE PRIMARY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 SE 47TH ST # 415
CAPE CORAL FL
33904-9661
US

IV. Provider business mailing address

1222 SE 47TH ST # 415
CAPE CORAL FL
33904-9661
US

V. Phone/Fax

Practice location:
  • Phone: 813-548-3344
  • Fax: 239-946-0232
Mailing address:
  • Phone: 813-548-3344
  • Fax: 239-946-0232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GREGG MACDONALD
Title or Position: OWNER
Credential: APRN
Phone: 239-848-2614