Organization
FORT MYERS FAMILY MEDICINE LLC
Active
Parent organization
FORT MYERS FAMILY MEDICINE PA
Other names
FORT MYERS FAMILY MEDICINE PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
FORT MYERS FAMILY MEDICINE PA
Authorized official
DR. HURSEL LEE ADKINS JR. D.O (EXECUTIVE MANAGING DIRECTOR)
(239) 433-4014
Entity
Organization
Contact information
Practice address
15661 SAN CARLOS BLVD, SUITE 2, FORT MYERS, FL 33908
(239) 433-4014
(239) 481-6247
Mailing address
15661 SAN CARLOS BLVD, SUITE 2, FORT MYERS, FL 33908-2797
(239) 433-4014
(239) 481-6247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS0005720
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268237100
—
FL
01
—
K1484
MEDICARE PTAN
FL
Enumeration date
09/14/2006
Last updated
06/20/2018
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