Healthcare Provider Details

I. General information

NPI: 1114847720
Provider Name (Legal Business Name): PHYSICIANS PRIMARY CARE OF S.W. FLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14651 PALM BEACH BLVD STE 100
FORT MYERS FL
33905-2331
US

IV. Provider business mailing address

12730 NEW BRITTANY BLVD STE 602
FORT MYERS FL
33907-4690
US

V. Phone/Fax

Practice location:
  • Phone: 239-369-2903
  • Fax:
Mailing address:
  • Phone: 239-275-5522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JON BURDZY
Title or Position: MANAGING PHYSICIAN
Credential: DO
Phone: 239-275-5522