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FORT MYERS FAMILY MEDICINE LLC NPI 1255436143


NPI Information

NPI: 1255436143
Provider Name: FORT MYERS FAMILY MEDICINE LLC

Former Legal Business Name: FORT MYERS FAMILY MEDICINE PA

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
15661 SAN CARLOS BLVD
SUITE 2
FORT MYERS, FL
ZIP 33908
Phone: (239) 433-4014
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FORT MYERS FAMILY MEDICINE LLC is a family medicine in Fort Myers, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FORT MYERS FAMILY MEDICINE LLC NPI is 1255436143. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Fort Myers Family Medicine Pa.

The provider's business location address is:

15661 SAN CARLOS BLVD
SUITE 2
FORT MYERS, FL
ZIP 33908
Phone: (239) 433-4014
Fax: (239) 481-6247

The provider's authorized official is Hursel Lee Adkins .
The authorized official title is Executive Managing Director and has the following contact phone number (239) 433-4014.

The enumeration date for this NPI number is 9/14/2006 and was last updated on 6/20/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineOS0005720FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1K1484OTHERFLORIDAMEDICARE PTAN
2268237100MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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