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General NPI Number Information
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NPI Number | 1619711363
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Entity Type | Organization
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Legal Business Name | FLORIDA COMMUNITY HEALTH PARTNERS
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Dates
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Enumeration Date | 06/19/2024
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 8140 COLLEGE PKWY STE 101
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City | FORT MYERS
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State | FL
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Zip | 33919-5189
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Country | US
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Telephone | 239-202-8128
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Fax |
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Provider Business Mailing Address
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Address Line | 8140 COLLEGE PKWY STE 101
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City | FORT MYERS
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State | FL
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Zip | 33919-5189
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Country | US
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Telephone | 239-202-8128
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | KATIE JOHNSON
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Credential |
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Telephone | 484-769-4369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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