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General NPI Number Information
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NPI Number | 1396713558
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE ASSOCIATES OF PUTNAM COUNTY, PA
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 108 N PALM AVE
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City | PALATKA
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State | FL
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Zip | 32177-2626
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Country | US
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Telephone | 386-325-9008
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Fax | 386-325-7098
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Provider Business Mailing Address
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Address Line | 108 N. PALM AVE.
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City | PALATKA
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State | FL
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Zip | 32177-2626
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Country | US
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Telephone | 386-325-9008
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Fax | 386-325-7098
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Authorized Official
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Title or Position | PRESIDENT
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Name | GINA CHRISTOPHER
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Credential | APRN
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Telephone | 386-325-9008
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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 | ME0044398
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License Number State | FL
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