=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659037562
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRIMARY CARE SOLUTIONS & MORE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2021
-----------------------------------------------------
Last Update Date | 01/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1701 SE HILLMOOR DR STE 7
-----------------------------------------------------
City | PORT SAINT LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34952-7552
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-480-5860
-----------------------------------------------------
Fax | 772-264-8310
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1701 SE HILLMOOR DR STE 7
-----------------------------------------------------
City | PORT SAINT LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34952-7552
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-480-5860
-----------------------------------------------------
Fax | 772-264-8310
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. MELISSA GIARRATANO
-----------------------------------------------------
Credential | APRN, FNP-BC
-----------------------------------------------------
Telephone | 772-480-5860
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------