NPIMap

Organization Active NPI

Family Medical Clinic, LLC

  • Health Service Clinic/Center
  • Kissimmee, FL
National Provider Identifier
1275089369
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
FAMILY MEDICAL CLINIC, LLC
Practice address
1952 N John Young Pkwy
Kissimmee, FL 34741-3221
Phone
(407) 483-7610
NPI assigned
Aug 29, 2016
Last updated
Aug 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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

Authorized official

Name
Gerardo Mena
Title
Owner
Phone
(407) 483-7610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

1952 N John Young Pkwy
Kissimmee, FL 34741-3221

Mailing address

1952 N John Young Pkwy
Kissimmee, FL 34741-3221
Phone (407) 483-7610

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Clinic LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1952 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 343-1284

NPI Registry JSON

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1275089369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413221",
            "telephone_number": "407-483-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413221",
            "telephone_number": "407-483-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "MENA",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-483-7610"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.