| Centerwell Senior Primary Care Of Longwood | |
|
485 S Ronald Reagan Blvd Longwood FL 32750-5408 | |
| (407) 834-4849 | |
| (407) 834-4905 |
| Full Name | Centerwell Senior Primary Care Of Longwood |
|---|---|
| Speciality | Internal Medicine |
| Location | 485 S Ronald Reagan Blvd, Longwood, Florida |
| 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 Of Longwood 4700 Millenia Blvd Ste 650 Orlando FL 32839-6013 Ph: (407) 447-7120 | Centerwell Senior Primary Care Of Longwood 485 S Ronald Reagan Blvd Longwood FL 32750-5408 Ph: (407) 834-4849 |
| NPI Number | 1801002183 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 05/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801002183 | NPI | - | NPPES |
| 025017707 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Florida) | Secondary |
| 207R00000X | Internal Medicine | (Florida) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
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