Healthcare Provider Details

I. General information

NPI: 1588596118
Provider Name (Legal Business Name): ELITE PRIMARY CARE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 NW 95TH ST
MIAMI FL
33150-2032
US

IV. Provider business mailing address

701 N FEDERAL HWY
HALLANDALE BEACH FL
33009-2449
US

V. Phone/Fax

Practice location:
  • Phone: 954-482-4747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ERIC JARQUIN
Title or Position: FINANCIAL CONTROLLER
Credential:
Phone: 954-651-8332