MEDICARE: NORTH FT. LAUDERDALE PRIMARY CARE ASSOCIATES

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
1	207Q00000X	Family Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1578045779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH FT. LAUDERDALE PRIMARY CARE ASSOCIATES

Provider Business Mailing Address
First Line	:	6101 WEBB RD STE 203
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-2865
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 W COMMERCIAL BLVD STE 20
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-3334
Country	:	US
Telephone Number	:	813-269-6426
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. PAUL PULCINI
Credential	:	MD
Telephone Number	:	813-269-6426

Provider Enumeration Date	:	09/04/2018
Last Update Date	:	09/04/2018

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