MEDICARE: CENTERWELL SENIOR PRIMARY CARE (FL) INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207Q00000X	Family Medicine Physician	FL
2	208D00000X	General Practice Physician
3	207R00000X	Internal Medicine Physician	FL

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	:	1922039254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTERWELL SENIOR PRIMARY CARE (FL) INC.

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	904B CYPRESS PKWY
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34759-3456
Country	:	US
Telephone Number	:	407-483-1400
Fax Number	:	407-483-1405

Authorized Official
Title or Position	:	SENIOR CREDENTIALING PROFESSIONAL
Name	:	ANGIE MARTINEZ
Credential	:
Telephone Number	:	407-447-7120

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	12/18/2024

Similar Medicare Providers

1053967638 — DR. FRANCIN JEAN BAPTISTE MD
Practice Location Address:

904B CYPRESS PKWY
KISSIMMEE, FL
34759-3456

Practice Phone: 407-543-0237
Practice Fax: 407-483-1405

1093797854 — TERESA B BRAVO M.D.
Practice Location Address:

904B CYPRESS PKWY
KISSIMMEE, FL
34759-3456

Practice Phone: 407-483-1400
Practice Fax: 407-483-1405

1487605432 — LUIS R RODRIGUEZ-LUNA MD
Practice Location Address:

920 CYPRESS PKWY
KISSIMMEE, FL
34759-3456

Practice Phone: 407-315-9460
Practice Fax: 407-846-0047

1407967755 — MR. JOSEPH RAMOS R.PH.
Practice Location Address:

900 CYPRESS PKWY
KISSIMMEE, FL
34759-3456

Practice Phone: 407-847-9803
Practice Fax: 407-847-7401

1710079678 — WAL-MART STORES EAST, LP
Practice Location Address:

904 CYPRESS PKWY
KISSIMMEE, FL
34759-3456

Practice Phone: 407-870-1903
Practice Fax:

1265604847 — DR. HUMERA SIDDIQUI O.D.
Practice Location Address:

904 CYPRESS PKWY , WALMART VISION CENTER
KISSIMMEE, FL
34759-3456

Practice Phone: 407-870-2405
Practice Fax: 407-870-2409

Directions to “CENTERWELL SENIOR PRIMARY CARE (FL) INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.