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General NPI Number Information
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NPI Number | 1831685460
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE PRACTITIONERS OF FLORIDA
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Dates
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Enumeration Date | 07/06/2018
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Last Update Date | 07/06/2018
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Provider Practice Location Address
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Address Line | 3769 GARLENDA AVE
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City | NORTH PORT
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State | FL
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Zip | 34286-7465
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Country | US
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Telephone | 941-236-6335
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Fax |
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Provider Business Mailing Address
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Address Line | 1181 S SUMTER BLVD # 217
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City | NORTH PORT
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State | FL
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Zip | 34287-2335
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | JENNIFER BIGELOW
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Credential | FNP-C
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Telephone | 941-236-6335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ARNP9292133
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License Number State | FL
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