MEDICARE: PRIMARY MEDICAL PHYSICIANS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center
2	208D00000X	General Practice Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225622095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY MEDICAL PHYSICIANS, LLC

Provider Business Mailing Address
First Line	:	6517 TAFT ST STE 102
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-4063
Country	:	US
Telephone Number	:	954-399-9014
Fax Number	:	954-367-7175

Provider Business Practice Location Address
First Line	:	6517 TAFT ST STE 102
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-4063
Country	:	US
Telephone Number	:	954-399-9014
Fax Number	:	954-367-7175

Authorized Official
Title or Position	:	MD
Name	:	RAMON BERENGUER
Credential	:	MD
Telephone Number	:	954-399-9014

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	02/24/2026

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