Provider Demographics
NPI:1902417272
Name:FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC
Entity Type:Organization
Organization Name:FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:QUINONEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-278-3600
Mailing Address - Street 1:PO BOX 919771
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-9771
Mailing Address - Country:US
Mailing Address - Phone:239-278-3600
Mailing Address - Fax:239-226-4650
Practice Address - Street 1:535 PINE ISLAND RD STE M
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-3700
Practice Address - Country:US
Practice Address - Phone:239-278-3600
Practice Address - Fax:239-226-4650
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-11
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)