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General NPI Number Information
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NPI Number | 1538054010
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 1926 VICTORIA AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-3414
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Country | US
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Telephone | 844-342-7935
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Fax |
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Provider Business Mailing Address
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Address Line | 2270 COLONIAL BLVD
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City | FORT MYERS
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State | FL
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Zip | 33907-1412
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Country | US
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Telephone | 239-344-2391
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | JORGE M QUINONEZ
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Credential | CMO
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Telephone | 239-278-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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