MEDICARE: PRIME CARE FAMILY HEALTH CENTERS 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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1427517531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME CARE FAMILY HEALTH CENTERS INC

Provider Business Mailing Address
First Line	:	9780 E INDIGO ST STE 202
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-5610
Country	:	US
Telephone Number	:	305-804-7947
Fax Number	:

Provider Business Practice Location Address
First Line	:	1747 45TH ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2167
Country	:	US
Telephone Number	:	561-508-8609
Fax Number	:	561-508-8697

Authorized Official
Title or Position	:	OWNER
Name	:	RAYMOND LEVY
Credential	:
Telephone Number	:	305-252-9485

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	03/18/2019

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