Healthcare Provider Details

I. General information

NPI: 1609782770
Provider Name (Legal Business Name): PRIMARY CARE ADVANCED PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1318 GLENLEIGH DR
OCOEE FL
34761-5726
US

IV. Provider business mailing address

PO BOX 231
OCOEE FL
34761-0231
US

V. Phone/Fax

Practice location:
  • Phone: 407-455-0990
  • Fax:
Mailing address:
  • Phone: 407-455-0990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YASHIKA ROWE
Title or Position: OWNER
Credential: APRN
Phone: 407-455-0990