Dr Miroslav Rafael Brzobohaty, DO - Medicare Internal Medicine in Fort Myers, FL

Dr Miroslav Rafael Brzobohaty, DO is a medicare enrolled "Internal Medicine" physician in Fort Myers, Florida. His current practice location is 9371 Cypress Lake Dr Ste 12, Fort Myers, Florida. You can reach out to his office (for appointments etc.) via phone at (239) 440-6456.

Dr Miroslav Rafael Brzobohaty is licensed to practice in Florida (license number OS17489) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1407413636.

Contact Information

Dr Miroslav Rafael Brzobohaty, DO
9371 Cypress Lake Dr Ste 12,
Fort Myers, FL 33919-4995
(239) 440-6456
(239) 236-0337

Map and Direction




Physician's Profile

Full NameDr Miroslav Rafael Brzobohaty
GenderMale
SpecialityInternal Medicine
Location9371 Cypress Lake Dr Ste 12, Fort Myers, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1407413636
  • Provider Enumeration Date: 05/22/2019
  • Last Update Date: 10/03/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4385009828
  • Enrollment ID: I20230504003279

Medical Identifiers

Medical identifiers for Dr Miroslav Rafael Brzobohaty such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1407413636NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine OS17489 (Florida)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Miroslav Rafael Brzobohaty allows following entities to bill medicare on his behalf.
Entity NameGulf Shore Internal Medicine, P.a.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255501268
PECOS PAC ID: 5294746129
Enrollment ID: O20060508000209
Entity NameConviva Medical Center Management, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649324278
PECOS PAC ID: 4284717422
Enrollment ID: O20080212000415

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Miroslav Rafael Brzobohaty is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Miroslav Rafael Brzobohaty, DO
7031 Sw 62nd Ave,
South Miami, FL 33143-4701

Ph: (305) 284-7761
Dr Miroslav Rafael Brzobohaty, DO
9371 Cypress Lake Dr Ste 12,
Fort Myers, FL 33919-4995

Ph: (239) 440-6456

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.