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General NPI Number Information
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NPI Number | 1861087744
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE PRIME CARE LLC
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 8927 HYPOLUXO RD. STE A3
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City | LAKE WORTH
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State | FL
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Zip | 33467
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Country | US
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Telephone | 561-366-7771
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Fax | 561-855-2718
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Provider Business Mailing Address
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Address Line | 8927 HYPOLUXO RD. STE A3
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City | LAKE WORTH
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State | FL
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Zip | 33467
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Country | US
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Telephone | 561-366-7771
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Fax | 561-855-2718
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | ORLANDO A. CUADRA
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Credential | MD
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Telephone | 561-366-7771
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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 |
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License Number State |
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