Healthcare Provider Details

I. General information

NPI: 1811607955
Provider Name (Legal Business Name): PRECISION PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10979 LOST LAKE DR APT 221
NAPLES FL
34105-3169
US

IV. Provider business mailing address

21251 PELICAN SOUND DR UNIT 101
ESTERO FL
33928-5936
US

V. Phone/Fax

Practice location:
  • Phone: 561-662-4050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JASON RICHICHI
Title or Position: DIRECTOR
Credential:
Phone: 843-749-2220