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General NPI Number Information
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NPI Number | 1164480307
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Entity Type | Organization
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Legal Business Name | PRIMECARE HOSPITALIST GROUP LLC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 07/12/2011
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Provider Practice Location Address
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Address Line | 26838 TANIC DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-4617
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Country | US
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Telephone | 813-991-1100
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Fax | 813-991-1200
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Provider Business Mailing Address
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Address Line | 26838 TANIC DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-4617
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Country | US
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Telephone | 813-991-1100
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Fax | 813-991-1200
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JAMILA WYSE ATKINSON
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Credential | MHA
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Telephone | 813-991-1100
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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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