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General NPI Number Information
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NPI Number | 1770072126
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Entity Type | Organization
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Legal Business Name | PRIMARY PHYSICIANS FLORIDA GROUP
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 220 N WESTMONTE DR STE D
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3360
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Country | US
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Telephone | 813-468-0271
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Fax |
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Provider Business Mailing Address
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Address Line | 3956 TOWN CTR BLVD # 598
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City | ORLANDO
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State | FL
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Zip | 32837-6103
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Country | US
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Telephone | 813-468-0271
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Fax |
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Authorized Official
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Title or Position | PRESISDENT
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Name | ELIZABETH ECHEVARRIA
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Credential | DC
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Telephone | 813-468-0271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH11075
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License Number State | FL
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