Healthcare Provider Details

I. General information

NPI: 1245104009
Provider Name (Legal Business Name): PRIME MEDICAL CLINIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10240 SW 56TH ST STE 101-102
MIAMI FL
33165-7071
US

IV. Provider business mailing address

10240 SW 56TH ST STE 101-102
MIAMI FL
33165-7071
US

V. Phone/Fax

Practice location:
  • Phone: 786-536-2414
  • Fax:
Mailing address:
  • Phone: 786-536-2414
  • Fax: 305-468-3954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NATHALY CASTRO STINCER
Title or Position: BUSINESS OWNER
Credential: MSN APRN FNP
Phone: 786-536-2414