MEDICARE: CARBON HEALTH PRIMARY CARE OF FLORIDA PA

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

General Provider Information

NPI Number	:	1518622315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARBON HEALTH PRIMARY CARE OF FLORIDA PA

Provider Business Mailing Address
First Line	:	300 CALIFORNIA ST FL 7
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-1415
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9116 W BOWLES AVE STE 3A
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80123-3476
Country	:	US
Telephone Number	:	303-904-2600
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MARLEY PAGE
Credential	:
Telephone Number	:	417-861-9739

Provider Enumeration Date	:	11/05/2021
Last Update Date	:	06/25/2025

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