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NPI Code Detail

MEDICARE: MOTHER DAUGHTER PRIMARY CARE LLC

MEDICARE: MOTHER DAUGHTER PRIMARY CARE LLC
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
1207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447715305
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOTHER DAUGHTER PRIMARY CARE LLC
Provider Business Mailing Address
First Line : 10 FAIRWAY DR STE 305
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1802
Country : US
Telephone Number : 954-744-0020
Fax Number : 754-318-6211
Provider Business Practice Location Address
First Line : 10 FAIRWAY DR STE 305
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1802
Country : US
Telephone Number : 954-744-0020
Fax Number : 754-318-6211
Authorized Official
Title or Position : APRN, FNP-BC
Name : MS. ANGELLA JOHN
Credential :
Telephone Number : 954-744-0020
Provider Enumeration Date : 02/05/2019
Last Update Date : 01/08/2025

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Directions to “MOTHER DAUGHTER PRIMARY CARE LLC ” Practice Location

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