Individual provider Active NPI

Rolando Tomas Otero, M.D.

  • Pediatrics Physician
  • Fort Myers, FL
National Provider Identifier
1831396472
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME0102039 Issued in FL
Practice address
13770 Plantation Rd Ste 1
Fort Myers, FL 33912-4460
Phone
(239) 689-5561
Fax
(239) 689-5958
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME0102039 FL Primary

Addresses

Primary practice location

13770 Plantation Rd Ste 1
Fort Myers, FL 33912-4460

Mailing address

13770 Plantation Rd Ste 1
Fort Myers, FL 33912-4460
Phone (239) 689-5561

Other identifiers 1

IdentifierTypeStateIssuer
000259900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0102039FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Myers Pediatrics LLC Pediatrics CurrentSince Apr 20, 2021 Accepting new patients

Locations

13770 Plantation Rd
Ste 1
Fort Myers, FL 33912
Phone (239) 689-5561

5285 Summerlin Rd
Ste 101
Fort Myers, FL 33919
Phone (239) 281-4908

Interoperability endpoints

  • Direct secure messaging: rolandootero@fmpllc.allscriptsdirect.net

Organizations & group practices 1

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1831396472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13770 PLANTATION RD STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124460",
            "telephone_number": "239-689-5561",
            "fax_number": "239-689-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13770 PLANTATION RD STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124460",
            "telephone_number": "239-689-5561",
            "fax_number": "239-689-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO",
        "first_name": "ROLANDO",
        "middle_name": "TOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0102039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000259900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.