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SOUTH FLORIDA SURGICAL ASSOCIATES, LLC
NPI 1417604018
Surgery in Fort Myers, FL

Active since March 04, 2022
5611 SOLERA CT, FORT MYERS, FL 33919(941) 882-0805 Get Directions Write a Review

NPPES record last updated: January 21, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 11, 2023, Nov 3, 2023, Mar 4, 2022 (3 updates tracked since 2022).

About South Florida Surgical Associates, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH FLORIDA SURGICAL ASSOCIATES, LLC (NPI 1417604018) is a healthcare organization registered as a surgery in Fort Myers, Florida and active in the NPI registry since March 2022. The organization lists Paul Mark Bloomston, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1417604018
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameSOUTH FLORIDA SURGICAL ASSOCIATES, LLC
Location Address5611 SOLERA CTFort Myers, FL 33919-3432
Mailing Address5611 Solera CtFort Myers, FL 33919-3432 · (239) 339-7356
Phone(941) 882-0805
Organization SubpartNo
Authorized OfficialPaul Mark BloomstonPhysician/owner · (239) 339-7356
Enumeration DateMarch 4, 2022
Last NPPES UpdateJanuary 21, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 21, 2025
✔ NPI 1417604018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
5611 SOLERA CT, Fort Myers, FL 33919
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

South Florida Surgical Associates, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to South Florida Surgical Associates, LLC, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Kelly Dylik, APRN FNP-C
Nurse Practitioner
NPI 1184297103
8931 COLONIAL CENTER DR STE 400
Fort Myers, FL 33905
(239) 334-6626
✔ PECOS✔ Accepts Medicare6.4 mi
Paul Bloomston, MD
Surgical Oncology
NPI 1982658225
8925 COLONIAL CENTER DR STE 1000
Fort Myers, FL 33905
(239) 343-7400
✔ PECOS✔ Accepts Medicare6.4 mi
Casey Diaz De Nacimiento
Nurse Practitioner
NPI 1750125878
8925 COLONIAL CENTER DR STE 1000
Fort Myers, FL 33905
(239) 343-7400
✔ PECOS✔ Accepts Medicare6.4 mi
Jeffrey Renaud
Nurse Practitioner
NPI 1689405649
8925 COLONIAL CENTER DR STE 1000
Fort Myers, FL 33905
(239) 343-7400
✔ PECOS✔ Accepts Medicare6.4 mi
Meagan Walton, ARNP
Nurse Practitioner
NPI 1124258983
8925 COLONIAL CENTER DR STE 1000
Fort Myers, FL 33905
(239) 343-7400
✔ PECOS✔ Accepts Medicare6.4 mi
Matthew Baker, MD
Neurology
NPI 1154372167
3200 BAILEY LN STE 200
Naples, FL 34105
(239) 262-8971
✔ PECOS✔ Accepts Medicare27 mi
Jessica Cunniff Darcy, APRN, PMHNP-BC
Nurse Practitioner
NPI 1396230199
3674 S WASHINGTON ST
Grand Forks, ND 58201
(701) 205-3000
✔ PECOS✔ Accepts Medicare1,684 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Florida Surgical Associates, LLC's NPI number?

The NPI number for South Florida Surgical Associates, LLC is 1417604018. It was assigned to this organization in the NPPES registry on March 4, 2022.

Where is South Florida Surgical Associates, LLC located?

South Florida Surgical Associates, LLC is located at 5611 Solera Ct, Fort Myers, FL 33919. The listed phone number is (941) 882-0805.

What is South Florida Surgical Associates, LLC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is South Florida Surgical Associates, LLC enrolled in Medicare?

Yes. South Florida Surgical Associates, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through South Florida Surgical Associates, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to South Florida Surgical Associates, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5), Neurology (1) and Surgical Oncology (1). Of these, 5 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does South Florida Surgical Associates, LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list South Florida Surgical Associates, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for South Florida Surgical Associates, LLC was last updated on January 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.