Individual provider Active NPI

Lynette M Llerena, DO

  • Family Medicine Physician
  • Englewood, FL
National Provider Identifier
1649266115
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS0007766 Issued in FL
Practice address
3000 S McCall Rd
Englewood, FL 34224-8616
Phone
(941) 406-9029
Fax
(941) 406-9028
NPI assigned
Sep 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS0007766 FL Primary

Addresses

Primary practice location

3000 S McCall Rd
Englewood, FL 34224-8616

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 1

IdentifierTypeStateIssuer
44547OtherFLFL BC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927000720 FL Practitioner - Family Practice 4981720091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1065 Tamiami TRL N
Nokomis, FL 34275-2144
Phone (941) 477-2364

13807 Tamiami TRL
North Port, FL 34287-2069
Phone (941) 257-1108

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone (239) 936-1343

13815 Tamiami TRL
North Port, FL 34287-2069
Phone (941) 426-4900

13823 Tamiami TRL
North Port, FL 34287-2069
Phone (941) 888-0770

150 W McKenzie St
Punta Gorda, FL 33950-5500
Phone (941) 621-6476

171 Ctr Rd
Venice, FL 34285-5572
Phone (941) 499-5407

177 Ctr Rd
Venice, FL 34285-5572
Phone (941) 207-5350

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2315 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 613-2222

2335 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 787-7665

2343 Aaron St
Port Charlotte, FL 33952-5305
Phone (941) 629-2900

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

3000 S McCall Rd
Englewood, FL 34224-8616
Phone (941) 406-9029

3571 Del Prado Blvd N
Suite 2
Cape Coral, FL 33909-5287
Phone (239) 656-6300

4130 Tamiami TRL
Suite 2
Port Charlotte, FL 33952-9207
Phone (941) 787-7100

900 Pine St
Suite 221
Englewood, FL 34223-4458
Phone (941) 548-1708

Hospital & facility affiliations

  • Millennium Home Care LLC Home health agency, Port Charlotte, FL, CCN 109401
  • Haven Home Health Care Home health agency, Venice, FL, CCN 687116
  • HCA Florida Healthcare at Home Home health agency, PT Charlotte, FL, CCN 108013
  • Trilogy Home Healthcare Home health agency, Sarasota, FL, CCN 109371
  • Patients First Home Care LLC Home health agency, Sarasota, FL, CCN 687176
  • Affinity Care of Charlotte and Desoto LLC Hospice, Port Charlotte, FL, CCN 101574
  • HCA Florida Englewood Hospital Hospital, Englewood, FL, CCN 100267
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS0007766FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC Family Medicine CurrentSince Dec 6, 2010 Accepting new patients
Millennium Physician Group LLC Family Medicine CurrentSince Dec 6, 2010 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

779 Medical Dr
Ste 6
Englewood, FL 34223
Phone (941) 681-3690

3000 S McCall Rd
Englewood, FL 34224
Phone (941) 406-9029

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: lynette.llerena.1@4290.direct.athenahealth.com

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1649266115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 S MCCALL RD",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342248616",
            "telephone_number": "941-406-9029",
            "fax_number": "941-406-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLERENA",
        "first_name": "LYNETTE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0007766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BC",
            "identifier": "44547",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, FL

Sources for this page

Verify at the official NPI Registry.