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General NPI Number Information
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NPI Number | 1770717381
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Entity Type | Organization
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Legal Business Name | PRIME CARE MEDICAL, INC.
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 02/16/2018
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Provider Practice Location Address
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Address Line | 5621 STRAND BLVD STE 206
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City | NAPLES
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State | FL
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Zip | 34110-7303
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Country | US
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Telephone | 239-591-5979
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Fax | 239-308-4547
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Provider Business Mailing Address
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Address Line | 3876 GIBRALTER DR
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City | NAPLES
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State | FL
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Zip | 34119-8647
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Country | US
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Telephone | 239-597-0190
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Fax | 239-597-7312
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAJID WAZIR
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Credential | M.D.
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Telephone | 239-591-5979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME 103428
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License Number State | FL
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