Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Suncoast Integrated Medical Center LLC

Organization Family Medicine Physician · NPI 1124636196

Suncoast Integrated Medical Center LLC is a Family Medicine Physician in Fort Myers, Florida. Works from 2 locations. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3840 Colonial Blvd Ste 1
Fort Myers, FL 33966-1126
Phone: (855) 778-6262
Fax: (855) 778-3262
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 681 Goodlette-Frank Rd N Ste 130, Naples, FL 34102-5612 — (855) 778-6262

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1124636196
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Scott Wadman — Coo · (855) 778-6262
Other names Suncoast Regenerative Medical Clinic Llc
NPI enumeratedJuly 16, 2020
Last updated in NPPESJuly 5, 2023
Certification dateJuly 5, 2023
Mailing address3840 Colonial Blvd Ste 1, Fort Myers, FL 33966-1126

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