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Organization
FAMILY UNIVERSAL MEDICAL CENTER, LLC
Active
Organization
FAMILY UNIVERSAL MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OTNIEL HERNANDEZ DNP, FNP-BC (CEO)
(305) 833-4707
Entity
Organization
Contact information
Practice address
4531 DELEON ST STE 207, FORT MYERS, FL 33907-1280
(239) 220-5115
(239) 201-2601
Mailing address
4531 DELEON ST STE 207, FORT MYERS, FL 33907-1280
(239) 220-5115
(239) 201-2601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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