=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033696836
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRIME CARE FAMILY HEALTH CENTERS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2018
-----------------------------------------------------
Last Update Date | 11/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2840 N HIAWASSEE RD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32818-3319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-378-6288
-----------------------------------------------------
Fax | 407-648-5023
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9780 E INDIGO ST STE 202
-----------------------------------------------------
City | PALMETTO BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-5610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-804-7947
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RAYMOND LEVY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-252-9485
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------