Individual provider Active NPI

Robert Anthony Otero, MSN, FNP-BC

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1033400122
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3317762 Issued in FL
Practice address
3098 Eagle Crossing Dr
Kissimmee, FL 34746-3160
Phone
(407) 201-2680
Fax
(407) 201-2680
NPI assigned
Apr 25, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP3317762 FL Primary

Addresses

Primary practice location

3098 Eagle Crossing Dr
Kissimmee, FL 34746-3160

Mailing address

3098 Eagle Crossing Dr
Kissimmee, FL 34746-3160
Phone (407) 201-2680

Other identifiers 1

IdentifierTypeStateIssuer
ARNP3317762OtherFLARNP LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130626000644 FL Practitioner - Nurse Practitioner 2961640255 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
001858NYMDBehavioral Analyst
ARNP3317762FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Group Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Primary Care in the Home, Inc Family CurrentSince Jan 29, 2023 Accepting new patients
Florida Urgent Care Center, LLC. PastSince Jan 1, 2025 Accepting new patients

Locations

1020 Mason Ave
Daytona Beach, FL 32117
Phone (386) 317-5149

141 N 6th St
Haines City, FL 33844
Phone (407) 201-7918

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1033400122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3098 EAGLE CROSSING DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463160",
            "telephone_number": "407-201-2680",
            "fax_number": "407-201-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3098 EAGLE CROSSING DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463160",
            "telephone_number": "407-201-2680",
            "fax_number": "407-201-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-25",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3317762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE NUMBER",
            "identifier": "ARNP3317762",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.