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General NPI Number Information
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NPI Number | 1174356505
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Entity Type | Organization
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Legal Business Name | DOWNTOWN PRIMARY CLINIC LLC
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 150 W MICHIGAN ST
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City | ORLANDO
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State | FL
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Zip | 32806-4463
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Country | US
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Telephone | 407-863-9111
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Fax | 407-613-5085
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Provider Business Mailing Address
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Address Line | PO BOX 568368
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City | ORLANDO
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State | FL
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Zip | 32856-8368
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Country | US
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Telephone | 407-863-9111
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Fax | 407-613-5085
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Authorized Official
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Title or Position | ADMIN
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Name | LASHUNDA STANDIFER
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Credential |
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Telephone | 407-863-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 111NR0200X
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Taxonomy Name | Radiology Chiropractor
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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