IMMOKALEE FAMILY DOCTOR'S CLINIC, LLC
NPI 1801157839
General Practice in Immokalee, FL

Q: What is Immokalee Family Doctor's Clinic, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since June 06, 2012CLIA 10D2076772 · Waiver

555 N 15TH ST UNIT A, IMMOKALEE, FL 34142(239) 657-2779(239) 657-3335 Get Directions Write a Review

NPPES record last updated: April 25, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 25, 2022, Apr 12, 2022, Feb 25, 2022 (3 updates tracked since 2022).

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About Immokalee Family Doctor's Clinic, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMMOKALEE FAMILY DOCTOR'S CLINIC, LLC (NPI 1801157839) is a healthcare organization registered as a general practice in Immokalee, Florida and active in the NPI registry since June 2012. The organization holds a CLIA Waiver certificate valid through April 24, 2028 and lists Andrea Keppel, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1801157839

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameIMMOKALEE FAMILY DOCTOR'S CLINIC, LLC

Location Address555 N 15TH ST UNIT AImmokalee, FL 34142-2824

Mailing Address555 N 15th St Unit AImmokalee, FL 34142-2824 · (239) 657-2779 · Fax (239) 657-3335

Phone(239) 657-2779

Fax(239) 657-3335

Organization SubpartNo

Authorized OfficialAndrea KeppelOffice Manager · (239) 657-2779

Enumeration DateJune 6, 2012

Last NPPES UpdateApril 25, 20223 updates tracked since enumeration

NPPES CertifiedApril 25, 2022

✔ NPI 1801157839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in FL · ME42490

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

555 N 15TH ST UNIT A, Immokalee, FL 34142

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Other Identifiers 1

Medicaid113836500FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2076772

Immokalee Family Doctors Clinic LLC · Immokalee, FL

Active · expires Apr 24, 2028

CLIA Number10D2076772

Laboratory TypePhysician Office

Certificate Effective DateApril 25, 2026

Certificate Expiration DateApril 24, 2028

Laboratory DirectorJuan R. Puerto

Laboratory Phone(239) 657-2779

Laboratory LocationImmokalee Family Doctors Clinic LLC555 N 15th St Ste A, Immokalee, FL 34142

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JUAN RIGOBERTO PUERTO M.D.

General Practice

555 N 15TH ST UNIT A
IMMOKALEE, FL 34142

Collier County (239) 657-2779

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Immokalee Family Doctor's Clinic, LLC's NPI number?

The NPI number for Immokalee Family Doctor's Clinic, LLC is 1801157839. It was assigned to this organization in the NPPES registry on June 6, 2012.

Where is Immokalee Family Doctor's Clinic, LLC located?

Immokalee Family Doctor's Clinic, LLC is located at 555 N 15th St Unit A, Immokalee, FL 34142. The listed phone number is (239) 657-2779.

What is Immokalee Family Doctor's Clinic, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Immokalee Family Doctor's Clinic, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2076772) is associated with this NPI, valid through April 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Immokalee Family Doctor's Clinic, LLC accept?

Health plans from Ambetter Health and Ambetter of Alabama list Immokalee Family Doctor's Clinic, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Immokalee Family Doctor's Clinic, LLC was last updated on April 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.