Family Universal Medical Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAMILY UNIVERSAL MEDICAL CENTER, LLC

Practice address

4531 Deleon St Ste 207
Fort Myers, FL 33907-1280

Phone

(239) 220-5115

Fax

(239) 201-2601

NPI assigned

Mar 5, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Otniel Hernandez, DNP, FNP-BC

Title

Ceo

Phone

(305) 833-4707

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23289/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1881289387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 DELEON ST STE 207",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071280",
            "telephone_number": "239-220-5115",
            "fax_number": "239-201-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 DELEON ST STE 207",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071280",
            "telephone_number": "239-220-5115",
            "fax_number": "239-201-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY UNIVERSAL MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "OTNIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-833-4707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Fort Myers, FL
• Providers in Fort Myers, 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 Mar 5, 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.