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

Serge Mistivar, DO

Individual provider Family Medicine Physician · NPI 1609080126

Serge Mistivar, DO is a Family Practice in Immokalee, Florida. Qualified in 2000, 26 years ago. Practices with Department of State Hospitals, a 276-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
26
Licensed in
GA
In the registry since
2007
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1454 Madison Ave W
Immokalee, FL 34142-2200
Phone: (239) 658-3064
Fax: (239) 658-3175
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 064865 (GA)

Record details

NPI number1609080126
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 10, 2007
Last updated in NPPESJanuary 7, 2015
Mailing address1454 Madison Ave W, Immokalee, FL 34142-2200

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Department Of State Hospitals — 276 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Immokalee