MEDICARE: DR. MARY MAGNO MOURACADE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME65887	FL
2	207RA0401X	Addiction Medicine (Internal Medicine) Physician	ME65887	FL
3	207RN0300X	Nephrology Physician	ME65887	FL

General Provider Information

NPI Number	:	1194776989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY MAGNO MOURACADE M.D.

Provider Business Mailing Address
First Line	:	7981 GLADIOLUS DR
Second Line	:
City	:	FT MYERS
State	:	FL
Zip	:	33908-4154
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7981 GLADIOLUS DR
Second Line	:
City	:	FT MYERS
State	:	FL
Zip	:	33908-4154
Country	:	US
Telephone Number	:	239-939-0999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	03/12/2024

Similar Medicare Providers

1336190073 — MRS. MICHELLE MAHANEY ARNP
Practice Location Address:

7981 GLADIOLUS DR
FT MYERS, FL
33908-4154

Practice Phone: 239-425-6629
Practice Fax: 239-425-0795

1245281864 — DR. JOEL VANSICKLER M.D.
Practice Location Address:

7981 GLADIOLUS DR
FT MYERS, FL
33908-4154

Practice Phone: 239-939-0999
Practice Fax:

1205888955 — DR. RONALD DELANS M.D.
Practice Location Address:

7981 GLADIOLUS DR
FT MYERS, FL
33908-4154

Practice Phone: 239-425-6629
Practice Fax: 239-425-0795

1881646602 — DR. EVAN GROSS M.D.
Practice Location Address:

7981 GLADIOLUS DR
FT MYERS, FL
33908-4154

Practice Phone: 239-939-0999
Practice Fax:

1427044254 — ANITA ROSE WEIBEL
Practice Location Address:

538 HUNTINGTON HILLS DR
FT COLLINS, CO
80525-4154

Practice Phone: 970-226-4154
Practice Fax:

1508816620 — SHEILA M ODAY APRN
Practice Location Address:

7981 GLADIOLUS DR
FORT MYERS, FL
33908-4154

Practice Phone: 239-939-0999
Practice Fax: 239-939-1070

Directions to “ DR. MARY MAGNO MOURACADE M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.