MEDICARE: HOSPITALIST GROUP OF SW FL PA

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3718134	OTHER	FL	CIGNA
2	38944	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	DD9266	OTHER	FL	RAILROAD PROVIDER NUMBER

General Provider Information

NPI Number	:	1245248517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITALIST GROUP OF SW FL PA

Provider Business Mailing Address
First Line	:	708 DEL PRADO BLVD
Second Line	:	S-9
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-5616
Country	:	US
Telephone Number	:	239-574-5864
Fax Number	:	239-574-1451

Provider Business Practice Location Address
First Line	:	708 DEL PRADO BLVD
Second Line	:	SUITE 9
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-5616
Country	:	US
Telephone Number	:	239-574-2644
Fax Number	:	239-574-1451

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANTONY MATHEW
Credential	:	MD
Telephone Number	:	239-574-2644

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/23/2009

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Directions to “HOSPITALIST GROUP OF SW FL PA ” Practice Location

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