Old Town Community Health Center

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME0049975 Issued in FL

Legal business name

OLD TOWN COMMUNITY HEALTH CENTER

Practice address

3134 Northside Dr
Key West, FL 33040-8004

Phone

(305) 296-8593

NPI assigned

Apr 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ivis Fonseca

Title

Billing Manager

Phone

(305) 292-3600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548488778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3134 NORTHSIDE DR",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330408004",
            "telephone_number": "305-296-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 NORTHSIDE DR",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330408004",
            "telephone_number": "305-296-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONSECA",
        "authorized_official_first_name": "IVIS",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "305-292-3600"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME0049975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oasis at Key West Nursing and Rehab LLC (Oasis at the Conch Republic Nursing and Rehab)
• Kathy Oconnell, ARNP, FNP-BC
• Andrew Louis Oconnor, PH.D.
• Paul Oien, PHARMD
• Priscilla Michelle Okeefe
• Old Town Medical Centers, LLC
• Robert M Olson, MD
• Mohamed Omar
• James Nelson Ong, D.M.D.
• Noah Opalsky

• General Practice Physician in Key West, FL
• Providers in Key West, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.