Healthcare Provider Details

I. General information

NPI: 1205002276
Provider Name (Legal Business Name): SAGAR V. MEHTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 S HEALTHPARK DR STE 110
FORT MYERS FL
33908-3630
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-6202
  • Fax: 239-343-4159
Mailing address:
  • Phone: 239-343-6202
  • Fax: 239-343-4159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME160003
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD443261
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD443261
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: