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General NPI Number Information
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NPI Number | 1710434485
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Entity Type | Organization
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Legal Business Name | PRIMECARE FAMILY CENTERS CORP
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Dates
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Enumeration Date | 09/09/2016
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Last Update Date | 10/24/2016
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Provider Practice Location Address
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Address Line | 4131 SW 6TH ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-2057
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Country | US
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Telephone | 305-442-2228
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Fax | 305-442-2207
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Provider Business Mailing Address
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Address Line | 1914 NW 84TH AVE
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City | DORAL
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State | FL
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Zip | 33126-1030
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Country | US
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Telephone | 305-442-2228
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Fax | 305-442-2207
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NERELYS PEREZ
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Credential |
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Telephone | 305-442-2228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME43821
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME45472
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License Number State | FL
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