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General NPI Number Information
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NPI Number | 1023497286
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE MEDICAL CENTER INC
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Dates
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Enumeration Date | 05/21/2015
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | 311 NE 8TH ST SUITE 109
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City | HOMESTEAD
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State | FL
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Zip | 33030-4738
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Country | US
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Telephone | 305-245-9222
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Fax | 305-428-2602
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Provider Business Mailing Address
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Address Line | 311 NE 8TH ST SUITE 109
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City | HOMESTEAD
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State | FL
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Zip | 33030-4738
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Country | US
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Telephone | 305-245-9222
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Fax | 305-428-2602
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. RAQUEL MARIA ARRAZOLA
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Credential |
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Telephone | 305-245-9222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME66843
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License Number State | FL
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