MEDICARE: SANTE PLUS MEDICAL CENTER

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	261QP2300X	Primary Care Clinic/Center
2	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639759475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTE PLUS MEDICAL CENTER

Provider Business Mailing Address
First Line	:	3822 BROADWAY STE A&B
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8148
Country	:	US
Telephone Number	:	239-603-2377
Fax Number	:	561-293-7717

Provider Business Practice Location Address
First Line	:	3822 BROADWAY STE A&B
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8148
Country	:	US
Telephone Number	:	239-603-2377
Fax Number	:	561-293-7717

Authorized Official
Title or Position	:	PRACTICE ADMIN
Name	:	MEGAN HAAPANEN
Credential	:
Telephone Number	:	239-482-8788

Provider Enumeration Date	:	04/14/2021
Last Update Date	:	01/20/2023

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Directions to “SANTE PLUS MEDICAL CENTER ” Practice Location

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