| 1 Primary Care | |
|
2140 Kingsley Ave Ste 2 Orange Park FL 32073-5129 | |
| (999) 999-9999 | |
| Not Available |
| Full Name | 1 Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 2140 Kingsley Ave Ste 2, Orange Park, Florida |
| Authorized Official Name and Position | John Distefano (BUSINESS MANAGER) |
| Authorized Official Contact | 3523173214 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 1 Primary Care 1548 Maple Leaf Ln Fleming Island FL 32003-8225 Ph: (904) 752-0215 | 1 Primary Care 2140 Kingsley Ave Ste 2 Orange Park FL 32073-5129 Ph: (999) 999-9999 |
| NPI Number | 1851146500 |
|---|---|
| Provider Enumeration Date | 04/17/2024 |
| Last Update Date | 08/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851146500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
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