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General NPI Number Information
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NPI Number | 1861959348
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Entity Type | Organization
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Legal Business Name | PRIMARY PHYSICIANS OF FLORIDA
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 02/21/2019
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Provider Practice Location Address
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Address Line | 2559 E IRLO BRONSON MEMORIAL HWY
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City | KISSIMMEE
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State | FL
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Zip | 34744-4993
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Country | US
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Telephone | 407-482-7441
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Fax | 407-483-4015
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Provider Business Mailing Address
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Address Line | 2559 E IRLO BRONSON MEMORIAL HWY
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City | KISSIMMEE
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State | FL
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Zip | 34744-4993
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Country | US
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Telephone | 407-482-7441
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Fax | 407-483-4015
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RAFAEL MARTINEZ
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Credential | MD
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Telephone | 408-482-7441
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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 |
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License Number State |
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