Fernhill Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME 83819 Issued in FL

Legal business name

FERNHILL FAMILY MEDICINE LLC

Practice address

4601 N Highway 19a
Mount Dora, FL 32757-2039

Phone

(352) 589-9090

Fax

(352) 589-1433

NPI assigned

Jan 8, 2007

Last updated

Oct 26, 2010By 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

Dr. Kumaran Kondath Mohan, MD

Title

Direct Owner

Phone

(352) 589-9090

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1871641209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 N HIGHWAY 19A",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572039",
            "telephone_number": "352-589-9090",
            "fax_number": "352-589-1433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 N HIGHWAY 19A",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572039",
            "telephone_number": "352-589-9090",
            "fax_number": "352-589-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERNHILL FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "MOHAN",
        "authorized_official_first_name": "KUMARAN",
        "authorized_official_middle_name": "KONDATH",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "352-589-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 83819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265990500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandy Feagan
• Yvonne Feavearyear, LMT
• Coralys Feliciano, RBT
• Mariah Feliciano
• Raymund Ferguson, RBT
• Caridad S Ferree, PHARMD
• William Shane Files, D.V.M.
• Denise Fine, LPN
• Emily Marie Fine
• First Image Optical LC

• Family Medicine Physician in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.