Aspire Primary Care | |
1715 Se Tiffany Ave Port St Lucie FL 34952-7511 | |
(772) 618-2121 | |
Not Available |
Full Name | Aspire Primary Care |
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Speciality | Clinic/Center |
Location | 1715 Se Tiffany Ave, Port St Lucie, Florida |
Authorized Official Name and Position | Neysa Batiz (MEMBER) |
Authorized Official Contact | 7726182121 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Aspire Primary Care 10570 Sw Capraia Way Port St Lucie FL 34986-2885 Ph: (772) 618-2121 | Aspire Primary Care 1715 Se Tiffany Ave Port St Lucie FL 34952-7511 Ph: (772) 618-2121 |
NPI Number | 1184356354 |
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Provider Enumeration Date | 06/27/2022 |
Last Update Date | 04/14/2023 |
Medicare PECOS PAC ID | 3375910920 |
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Medicare Enrollment ID | O20221110001625 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184356354 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Juan De Dios Maldonado |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1679665814 PECOS PAC ID: 9830133081 Enrollment ID: I20140905000484 |
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