MEDICARE: MEDICAL CENTRAL, LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1699577734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL CENTRAL, LLC

Provider Business Mailing Address
First Line	:	114 DEL PRADO BLVD S STE 100
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-1724
Country	:	US
Telephone Number	:	239-471-2874
Fax Number	:

Provider Business Practice Location Address
First Line	:	11390 PALM BEACH BLVD STE 300
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-5921
Country	:	US
Telephone Number	:	239-666-2652
Fax Number	:	239-666-2698

Authorized Official
Title or Position	:	CEO
Name	:	ANIA RIDRIGUEZ
Credential	:
Telephone Number	:	239-443-5300

Provider Enumeration Date	:	03/27/2025
Last Update Date	:	03/27/2025

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Directions to “MEDICAL CENTRAL, LLC ” Practice Location

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