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General NPI Number Information
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NPI Number | 1194476101
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Entity Type | Organization
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Legal Business Name | PRIMARILY YOU LLC
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 239 AUGUST FERN LOOP
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City | MOUNT DORA
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State | FL
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Zip | 32757-2806
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Country | US
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Telephone | 352-316-7205
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Fax | 870-408-4059
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Provider Business Mailing Address
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Address Line | 18848 US HIGHWAY 441 # 423
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City | MOUNT DORA
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State | FL
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Zip | 32757-6700
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Country | US
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Telephone |
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Fax | 870-408-4059
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Authorized Official
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Title or Position | CO-OWNER
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Name | JESSICA BROOKS
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Credential |
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Telephone | 501-504-3307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 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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