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General NPI Number Information
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NPI Number | 1477717544
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Entity Type | Organization
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Legal Business Name | PRIME CARE FAMILY HEALTH CENTERS INC
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 1706 E SEMORAN BLVD STE 101
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City | APOPKA
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State | FL
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Zip | 32703-5610
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Country | US
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Telephone | 407-880-0800
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Fax | 407-880-0808
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Provider Business Mailing Address
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Address Line | 1706 E SEMORAN BLVD STE 101
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City | APOPKA
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State | FL
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Zip | 32703-5610
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Country | US
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Telephone | 407-880-0800
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Fax | 407-880-0808
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARYSE NAU
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Credential |
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Telephone | 407-880-0800
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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 | ME48249
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License Number State | FL
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