Fmic 2, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FMIC 2, LLC

Practice address

2470 E Highway 50 Ste B
Clermont, FL 34711-6016

Phone

(407) 944-9355

Fax

(407) 933-1237

NPI assigned

Dec 1, 2019

Organization subpart

No

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

Authorized official

Name

Carmen O Gonzalez

Title

Administrator

Phone

(407) 944-9355

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1575158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575158400000",
    "number": "1982241600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414902",
            "telephone_number": "407-944-9355",
            "fax_number": "407-933-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 E HIGHWAY 50 STE B",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116016",
            "telephone_number": "407-944-9355",
            "fax_number": "407-933-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMIC 2, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-01",
        "last_updated": "2019-12-01",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-944-9355"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Manager@my-fmic.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2470 E Highway 50 Ste B",
            "city": "Clermont",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347116016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2019; 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.