Active NPI 1205017605 Individual Practitioner Male Practitioner

Dr. Nicholas Daniel Coppa , MD

Neurological Surgery • Cape Coral, FL

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Nicholas Coppa, MD is a certified Neurological Surgery practicing in Cape Coral, FL. With approximately 24 years of clinical experience since completing medical education in 2002, Dr. Coppa delivers high-quality medical care to the local community at 632 DEL PRADO BLVD N.

Dr. Coppa maintains professional affiliations with Medical Affiliates Of Cape Cod Inc, Lee Health System Inc, Physiotherapy Associates Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, insertion of cage or mesh device to spine bone and disc space during spine fusion. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

632 Del Prado Blvd N

Cape Coral, FL 339092278

Telephone 2393433800

Fax 2393434261

Associated Practice Facility / Clinic

🏢 Sypert Institute Pa Facility NPI 1104889534

Medicare Profile & Education

Medical School

Other

Graduation Year

2002

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Neurological Surgery in Cape Coral, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

24 Yrs Matches City Avg

City Avg: 24.0 Yrs

State Avg: 24.5 Yrs

Regional Practice Density

3 Specialists

Practicing in Cape Coral, FL (675 Statewide)

Telehealth Adoption Rate

33.3% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

69.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Coppa (24 Years) 24 Yrs

Cape Coral Specialty Average (24.0 Years) 24.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	159	130	$318.12	$129.91
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	139	139	$433.25	$168.73
99213 Established patient office or other outpatient visit, typically 15 minutes	107	98	$224.91	$92.22
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	102	86	$444.57	$180.74
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	61	47	$693.66	$181.03
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	56	56	$547.03	$222.12
63052 Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back	36	36	$705.06	$168.49
22633 Fusion of spine in lower back with partial removal of spine bone and disc	35	35	$4969.75	$1100.84
61783 Computer-assisted spinal procedure	27	27	$622.45	$223.44
22840 Placement of stabilizing device to back of 1 spine bone in neck	26	26	$2037.46	$497.02
20939 Harvest of bone marrow for spine surgery graft	24	24	$187.45	$67.60
22842 Placement of stabilizing device to back, 3-6 spine bone segments	23	23	$2046.40	$495.63
22614 Fusion of additional segment of spine	19	13	$1049.88	$243.44
22513 Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance	16	14	$1376.70	$502.66
63030 Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine	15	15	$2610.15	$853.21
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	13	12	$189.79	$77.98
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	12	12	$361.56	$129.05
69990 Use of operating microscope	12	12	$579.36	$209.09
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	12	12	$2959.92	$1009.16
22551 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc	11	11	$4570.51	$1666.34
61781 Computer-assisted procedure inside brain	11	11	$626.34	$227.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	153	134	$142.21	$58.00
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	148	148	$284.30	$114.59
99213 Established patient office or other outpatient visit, typically 15 minutes	144	125	$224.91	$92.26
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	100	70	$693.66	$174.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	71	69	$318.12	$130.12
63052 Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back	60	60	$705.06	$139.73
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$433.25	$164.54
22633 Fusion of spine in lower back with partial removal of spine bone and disc	40	40	$4969.75	$1109.54
22840 Placement of stabilizing device to back of 1 spine bone in neck	39	39	$2037.46	$351.82
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	28	28	$361.56	$133.01
61783 Computer-assisted spinal procedure	27	27	$622.45	$232.37
20939 Harvest of bone marrow for spine surgery graft	26	26	$187.45	$70.74
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	25	25	$352.53	$54.45
22842 Placement of stabilizing device to back, 3-6 spine bone segments	23	23	$2046.40	$543.15
63053 Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back	22	19	$527.74	$159.84
22630 Fusion of lower spine bone and partial removal of spine bone or disc through back, 1 disc	20	20	$4222.90	$656.32
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	17	17	$1284.16	$484.76
22634 Fusion of additional segment of spine with partial removal of spine bone and disc	16	13	$1329.40	$359.03
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	16	16	$444.57	$185.34
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	15	15	$2959.92	$959.47
22513 Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance	13	13	$1376.70	$519.49
22551 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc	11	11	$4570.51	$1736.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	177	148	$125.73	$55.45
99213 Established patient office or other outpatient visit, typically 15 minutes	145	122	$205.53	$89.06
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	118	118	$284.30	$112.71
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	89	81	$296.16	$118.30
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	65	45	$693.66	$157.12
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$433.25	$157.57
20939 Harvest of bone marrow for spine surgery graft	31	31	$187.45	$70.79
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	30	18	$273.52	$104.87
22840 Placement of stabilizing device to back of 1 spine bone in neck	27	27	$2037.46	$506.47
63052 Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back	25	25	$705.06	$156.51
22633 Fusion of spine in lower back with partial removal of spine bone and disc	22	22	$4969.75	$666.67
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	21	21	$2959.92	$913.05
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	21	19	$1284.16	$487.10
22842 Placement of stabilizing device to back, 3-6 spine bone segments	20	20	$2046.40	$417.36
61783 Computer-assisted spinal procedure	17	17	$622.45	$227.96
99231 Follow-up hospital inpatient care per day, typically 15 minutes	17	15	$103.14	$39.37
61510 Removal of bone from skull for removal of upper brain tumor	16	14	$5853.41	$1949.24
22513 Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance	16	16	$1376.70	$523.92
22630 Fusion of lower spine bone and partial removal of spine bone or disc through back, 1 disc	16	16	$4222.90	$1371.03
99221 Initial hospital inpatient care per day, typically 30 minutes	11	11	$267.45	$101.44
63030 Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine	11	11	$2610.15	$1005.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	212	159	$189.90	$93.52
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	159	159	$270.87	$117.04
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	137	117	$118.29	$56.49
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	73	55	$693.66	$154.23
22840 Placement of stabilizing device to back of 1 spine bone in neck	43	43	$2037.46	$434.54
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	39	27	$273.52	$106.85
22633 Fusion of spine in lower back with partial removal of spine bone and disc	36	36	$4969.75	$808.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	34	33	$280.73	$136.67
20939 Harvest of bone marrow for spine surgery graft	33	33	$187.45	$72.64
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	25	25	$2959.92	$859.77
99231 Follow-up hospital inpatient care per day, typically 15 minutes	23	23	$103.14	$39.70
61783 Computer-assisted spinal procedure	22	22	$622.45	$240.11
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	22	19	$4330.10	$501.13
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	22	19	$189.79	$74.34
22842 Placement of stabilizing device to back, 3-6 spine bone segments	21	21	$2046.40	$475.42
63048 Partial removal of spine bone with release of spinal cord and/or nerves	20	13	$565.53	$173.38
22513 Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance	20	20	$1376.70	$536.62
22630 Fusion of lower spine bone and partial removal of spine bone or disc through back, 1 disc	19	19	$4222.90	$1262.58
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$428.35	$176.60
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	18	17	$531.04	$207.16
22634 Fusion of additional segment of spine with partial removal of spine bone and disc	15	14	$1329.40	$342.02
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	13	13	$335.61	$190.71
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$361.56	$140.62
22852 Removal of posterior segmental spinal instrumentation	12	12	$1883.44	$216.27
63030 Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine	12	12	$2610.15	$863.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	346	208	$199.95	$79.31
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	100	100	$291.74	$113.78
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	99	58	$650.29	$172.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	67	60	$293.45	$115.67
22633 Fusion of spine in lower back with partial removal of spine bone and disc	45	45	$4652.27	$1025.45
20939 Harvest of bone marrow for spine surgery graft	38	38	$392.16	$75.51
22840 Placement of stabilizing device to back of 1 spine bone in neck	33	33	$1918.75	$465.70
61783 Computer-assisted spinal procedure	25	25	$591.37	$250.94
99442 Telephone medical discussion with physician, 11-20 minutes	22	20	$203.25	$78.15
22842 Placement of stabilizing device to back, 3-6 spine bone segments	18	18	$1939.45	$517.40
22634 Fusion of additional segment of spine with partial removal of spine bone and disc	18	17	$1256.83	$311.01
22552 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, each additional disc	17	12	$999.12	$407.18
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	16	16	$2785.81	$800.99
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	16	15	$40.49	$15.15
99441 Telephone medical discussion with physician, 5-10 minutes	15	14	$142.72	$45.73
22551 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc	13	13	$4269.95	$1707.21
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	13	13	$4114.45	$497.47
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$445.28	$174.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	422	280	$200.23	$78.20
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	177	177	$294.32	$114.24
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	61	60	$643.15	$180.54
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	54	52	$294.19	$114.45
22633 Fusion of spine in lower back with partial removal of spine bone and disc	50	49	$4583.63	$1119.78
22840 Placement of stabilizing device to back of 1 spine bone in neck	43	42	$1892.37	$552.30
20939 Harvest of bone marrow for spine surgery graft	39	38	$438.39	$71.42
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	35	35	$3115.18	$950.20
61783 Computer-assisted spinal procedure	30	29	$581.56	$253.39
22513 Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance	20	15	$1707.74	$557.06
22634 Fusion of additional segment of spine with partial removal of spine bone and disc	15	12	$1236.10	$176.91
63030 Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine	13	13	$2586.92	$913.88
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	13	13	$1583.11	$519.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	424	283	$195.83	$76.28
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	113	113	$289.31	$112.90
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	68	63	$626.90	$158.90
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	66	61	$286.79	$112.58
22633 Fusion of spine in lower back with partial removal of spine bone and disc	56	54	$4469.20	$1022.86
22840 Placement of stabilizing device to back of 1 spine bone in neck	44	43	$1843.51	$396.47
20939 Harvest of bone marrow for spine surgery graft	39	37	$427.26	$71.35
61783 Computer-assisted spinal procedure	27	26	$566.50	$250.88
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	25	24	$3758.50	$792.09
22513 Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance	23	21	$1670.98	$553.73
22634 Fusion of additional segment of spine with partial removal of spine bone and disc	21	17	$1210.39	$427.17
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	19	17	$1551.56	$511.84
22842 Placement of stabilizing device to back, 3-6 spine bone segments	17	17	$1849.53	$618.58
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	13	13	$477.15	$210.47
22612 Fusion of spine in lower back	11	11	$3820.07	$1301.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	297	215	$194.40	$72.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	124	112	$285.62	$106.26
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	92	59	$365.50	$197.28
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	87	87	$285.75	$107.12
22633 Fusion of spine in lower back with partial removal of spine bone and disc	43	42	$4450.13	$1224.82
99221 Initial hospital inpatient care per day, typically 30 minutes	34	32	$236.81	$97.33
22513 Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance	33	30	$8783.37	$510.73
22840 Placement of stabilizing device to back of 1 spine bone in neck	33	32	$1837.25	$526.61
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	33	32	$7576.98	$484.31
61783 Computer-assisted spinal procedure	30	29	$564.62	$232.04
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	30	30	$2648.32	$621.79
38220 Aspiration of bone marrow sample for diagnosis	28	28	$425.62	$30.53
22842 Placement of stabilizing device to back, 3-6 spine bone segments	23	23	$1843.03	$487.87
22552 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, each additional disc	20	14	$966.03	$393.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$433.48	$161.83
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	19	19	$170.01	$72.08
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	18	18	$382.49	$142.41
22634 Fusion of additional segment of spine with partial removal of spine bone and disc	17	12	$1200.10	$322.87
22551 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc	16	16	$4121.26	$1641.59
22612 Fusion of spine in lower back	15	15	$3809.68	$1232.39
63030 Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine	13	13	$2690.96	$917.39
20902 Harvest of graft from large bone	13	13	$686.94	$99.34

Medical Specialties & State Licenses

CMS Verified: 2025-09-24

Neurological Surgery Primary Specialty

NUCC Taxonomy Code: 207T00000X

State License FL ME174969

A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.

Neurological Surgery

NUCC Taxonomy Code: 207T00000X

State License WA MD60101352

Neurological Surgery

NUCC Taxonomy Code: 207T00000X

State License DC MD035600

Neurological Surgery

NUCC Taxonomy Code: 207T00000X

State License OR MD27964

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

127721600 (FL)

Hospital & Practice Group Affiliations

Lee Health System Inc

632 Del Prado Blvd N, Cape Coral, FL 339092278

Phone: 2397725577

Physiotherapy Associates Inc

860 Route 134, South Dennis, MA 026602577

Phone: 5083854212

Physiotherapy Associates Inc

860 Route 134, South Dennis, MA 026602577

Phone: 5083854212

Medical Affiliates Of Cape Cod Inc

46 N St, Hyannis, MA 026013845

Phone: 5088332639

Medical Affiliates Of Cape Cod Inc

27 Park St, Hyannis, MA 026015230

Phone: 5087711800

Secondary Practice Locations

46 North St

Hyannis, MA 026013845

Phone: 5087710006

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

34 Associated Practitioners

Dr. Wesley Faunce , MD

Neurological Surgery

NPI 1003878877

Doctor of Medicine (M.D.)

Serena Warf , PA

Physician Assistant

NPI 1073865804

Physician Assistant

Jerad Rardin

Nurse Practitioner

NPI 1083163042

Kaci Thomas

Physician Assistant - Surgical

NPI 1104677384

Dr. Rimal Dossani , MD

Neurological Surgery

NPI 1124316385

Doctor of Medicine (M.D.)

Delaney Semancik , PA

Physician Assistant

NPI 1124678636

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location September 24, 2025

Registered at 632 DEL PRADO BLVD N, CAPE CORAL, FL 339092278 (Tel: 2393433800)

📍

Updated Business Mailing Address September 24, 2025

Registered at PO BOX 2147, FORT MYERS, FL 339022147 (Tel: 2393433800)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 24, 2025

Neurological Surgery (License #ME174969 in FL)

✅

NPI Profile Active March 07, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location March 07, 2014

Registered at 46 NORTH ST, HYANNIS, MA 026013845 (Tel: 5087710006)

📍

Updated Business Mailing Address March 07, 2014

Registered at 46 NORTH ST, HYANNIS, MA 026013845 (Tel: 5087710006)

👤

Provider Name / Credentials Updated March 07, 2014

Recorded as NICHOLAS COPPA, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 07, 2014

Neurological Surgery (License #MD27964 in OR)

🟢

Initial NPI Registration & Enumeration November 14, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1205017605

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: November 14, 2007

Last Update: September 24, 2025

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

Po Box 2147

Fort Myers, FL 339022147

Phone: 2393433800

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.