Healthcare Provider Details

I. General information

NPI: 1023955929
Provider Name (Legal Business Name): PRIMEHEALTH FAMILY PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 N WEATHERSFIELD AVE
ALTAMONTE SPRINGS FL
32714-6821
US

IV. Provider business mailing address

140 N WEATHERSFIELD AVE
ALTAMONTE SPRINGS FL
32714-6821
US

V. Phone/Fax

Practice location:
  • Phone: 732-621-3697
  • Fax: 732-621-3697
Mailing address:
  • Phone: 732-621-3697
  • Fax: 732-621-3697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDRES M FERNANDEZ HERRERA
Title or Position: OWNER
Credential: NP
Phone: 732-621-3697