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General NPI Number Information
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NPI Number | 1215205240
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE ASSOCIATES OF PLANT CITY PL
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 108 SOUTHERN OAKS DR
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City | PLANT CITY
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State | FL
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Zip | 33563-1446
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Country | US
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Telephone | 813-907-0123
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7887
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-0116
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANISH SHARMA
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Credential | D.O.
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Telephone | 813-907-0123
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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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