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General NPI Number Information
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NPI Number | 1912322819
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Entity Type | Organization
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Legal Business Name | SUNCOAST PRIMARY CARE
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Dates
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Enumeration Date | 02/28/2014
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Last Update Date | 02/28/2014
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Provider Practice Location Address
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Address Line | 10489 N FLORIDA AVE
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City | CITRUS SPRINGS
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State | FL
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Zip | 34434-3268
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Country | US
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Telephone | 352-489-2486
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Fax | 352-489-5876
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Provider Business Mailing Address
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Address Line | 10489 N FLORIDA AVE
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City | CITRUS SPRINGS
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State | FL
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Zip | 34434-3268
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Country | US
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Telephone | 352-489-2486
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Fax | 352-489-5876
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Authorized Official
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Title or Position | DR.
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Name | DR. ALEX VILLACASTIN
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Credential | M.D
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Telephone | 352-527-9309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 9107081
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License Number State | FL
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