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General NPI Number Information
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NPI Number | 1720424021
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE PHYSICIANS GROUP
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 4308 ALTON RD SUITE 860
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City | MIAMI BEACH
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State | FL
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Zip | 33140-4556
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Country | US
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Telephone | 305-604-2888
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Fax | 305-604-2887
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Provider Business Mailing Address
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Address Line | 4308 ALTON RD SUITE 860
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City | MIAMI BEACH
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State | FL
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Zip | 33140-4556
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Country | US
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Telephone | 305-604-2888
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Fax | 305-604-2887
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY J MERLINO
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Credential | D.O.
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Telephone | 305-604-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 9257323
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License Number State | FL
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