| Centerwell Senior Primary Care-prairieville | |
|
17123 Commerce Centre Dr Prairieville LA 70769-3481 | |
| (407) 447-7120 | |
| Not Available |
| Full Name | Centerwell Senior Primary Care-prairieville |
|---|---|
| Speciality | Internal Medicine |
| Location | 17123 Commerce Centre Dr, Prairieville, Louisiana |
| Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
| Authorized Official Contact | 4074477120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerwell Senior Primary Care-prairieville 6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000 | Centerwell Senior Primary Care-prairieville 17123 Commerce Centre Dr Prairieville LA 70769-3481 Ph: (407) 447-7120 |
| NPI Number | 1518737766 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 08/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518737766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
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