MEDICARE: GENTLE MINDS FAMILY CLINIC CORP

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	363LF0000X	Family Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1346095247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLE MINDS FAMILY CLINIC CORP

Provider Business Mailing Address
First Line	:	1500 COLONIAL BLVD STE 226
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1026
Country	:	US
Telephone Number	:	239-502-4331
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 COLONIAL BLVD STE 226
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1026
Country	:	US
Telephone Number	:	239-502-4331
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SANDRA M DELGADO
Credential	:	APRN/ PMHNP/ FNP/DNP
Telephone Number	:	239-502-4331

Provider Enumeration Date	:	04/23/2024
Last Update Date	:	01/23/2026

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