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General NPI Number Information
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NPI Number | 1063120657
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Entity Type | Organization
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Legal Business Name | PRIME CARE HEALTH PARTNERS LLC
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 14024 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33184-3001
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Country | US
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Telephone | 786-536-5256
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Fax |
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Provider Business Mailing Address
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Address Line | 4960 SW 72ND AVE STE 206
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City | MIAMI
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State | FL
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Zip | 33155-5549
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Country | US
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Telephone | 305-972-3590
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Fax |
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Authorized Official
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Title or Position | COO
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Name | GLADYS GALLEGOS
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Credential |
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Telephone | 305-972-3590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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