Jaqueline Sousa Carvalho, FNP-BC is a medicare enrolled "Nurse Practitioner" physician in Fort Myers, Florida. Her current practice location is
12651 Whitehall Dr, Fort Myers, Florida. You can reach out to her office (for appointments etc.) via phone at
(239) 424-2030.
Jaqueline Sousa Carvalho is licensed to practice in Florida (license number APRN11033857) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003649476.
Physician's Profile
| Full Name | Jaqueline Sousa Carvalho |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 12651 Whitehall Dr, Fort Myers, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1003649476
- Provider Enumeration Date: 08/21/2024
- Last Update Date: 02/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 6608391396
- Enrollment ID: I20250415002256
Medical Identifiers
Medical identifiers for Jaqueline Sousa Carvalho such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003649476 | NPI | - | NPPES |
| 125563500 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208800000X | Urology | APRN11033857 (Florida) | Secondary |
| 363L00000X | Nurse Practitioner | APRN11033857 (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. Jaqueline Sousa Carvalho allows following entities to bill medicare on her behalf.
| Entity Name | Lee Health System Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942058557
PECOS PAC ID: 9335672146
Enrollment ID: O20241114001576 |
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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. Jaqueline Sousa Carvalho 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 Address | Practice Location Address |
|---|
Jaqueline Sousa Carvalho, FNP-BC
Po Box 2147,
Fort Myers, FL 33902-2147
Ph: (239) 343-7130 | Jaqueline Sousa Carvalho, FNP-BC
12651 Whitehall Dr,
Fort Myers, FL 33907-3626
Ph: (239) 424-2030 |
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