Healthcare Provider Details
I. General information
NPI: 1245273093
Provider Name (Legal Business Name): HERNANDO PASCO PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/13/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1785 NORTHPOINTE PKWY STE 300
LUTZ FL
33558-5742
US
IV. Provider business mailing address
PO BOX 850001, DEPT 8340
ORLANDO FL
32885-0001
US
V. Phone/Fax
- Phone: 855-536-7277
- Fax: 813-702-1133
- Phone: 813-536-7277
- Fax: 855-830-1722
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SANJAY
H
NAVADIA
Title or Position: PHYSICIAN
Credential: MD
Phone: 727-389-5146