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General NPI Number Information
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NPI Number | 1033909056
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Entity Type | Organization
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Legal Business Name | PENTUS HEALTH PRIMARY CARE WINTER SPRINGS LLC
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 253 WINDING HOLLOW BLVD
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4035
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Country | US
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Telephone | 844-973-6887
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Fax |
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Provider Business Mailing Address
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Address Line | 253 WINDING HOLLOW BLVD
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4035
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Country | US
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Telephone | 407-756-3474
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | IVAN REYES
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Credential |
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Telephone | 407-756-3474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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