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NPI Code Detail

MEDICARE: PRIMENET MEDICAL GROUP INC

MEDICARE: PRIMENET MEDICAL GROUP INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

General Provider Information

NPI Number : 1427014158
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIMENET MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 7189 PEMBROKE RD
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33023
Country : US
Telephone Number : 954-983-1220
Fax Number : 954-983-0687
Provider Business Practice Location Address
First Line : 7189 PEMBROKE RD
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33023
Country : US
Telephone Number : 954-983-1220
Fax Number : 954-983-0687
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. MAGGIE TORRES
Credential :
Telephone Number : 954-983-1220
Provider Enumeration Date : 04/21/2006
Last Update Date : 03/16/2011

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Directions to “PRIMENET MEDICAL GROUP INC ” Practice Location

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