# FORT MYERS FAMILY MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FORT MYERS FAMILY MEDICINE PA
- **Other names:** FORT MYERS FAMILY MEDICINE PA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255436143
- **Legal business name:** FORT MYERS FAMILY MEDICINE PA
- **Authorized official:** DR. HURSEL LEE ADKINS JR. D.O (EXECUTIVE MANAGING DIRECTOR)
- **Authorized official phone:** (239) 433-4014

## Contact information

- **Practice address:** 15661 SAN CARLOS BLVD, SUITE 2, FORT MYERS, FL 33908
- **Practice address phone:** (239) 433-4014
- **Practice address fax:** (239) 481-6247
- **Mailing address:** 15661 SAN CARLOS BLVD, SUITE 2, FORT MYERS, FL 33908-2797
- **Mailing address phone:** (239) 433-4014
- **Mailing address fax:** (239) 481-6247

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS0005720 | FL | Yes |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 06/20/2018