MEDICARE: ADVANCED PRIMARY CARE, INC

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	ME82723	FL

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	:	1316930902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PRIMARY CARE, INC

Provider Business Mailing Address
First Line	:	4028 TAMPA RD
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3205
Country	:	US
Telephone Number	:	813-814-9088
Fax Number	:	813-814-9077

Provider Business Practice Location Address
First Line	:	4028 TAMPA RD
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3205
Country	:	US
Telephone Number	:	813-814-9088
Fax Number	:	813-814-9077

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. AMANDA M WU
Credential	:	M.D.
Telephone Number	:	813-814-9088

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	09/21/2011

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