| Lifetime Medical Care Pa | |
|
2300 Park Ave Suite 203 Orange Park FL 32073-5571 | |
| (904) 278-0016 | |
| (904) 278-4217 |
| Full Name | Lifetime Medical Care Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2300 Park Ave, Orange Park, Florida |
| Authorized Official Name and Position | Nidal El Rimawi (PRESIDENT) |
| Authorized Official Contact | 9042780016 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Medical Care Pa 5000 Us Highway 17 Suite 18-302 Orange Park FL 32003-8231 Ph: (904) 278-0016 | Lifetime Medical Care Pa 2300 Park Ave Suite 203 Orange Park FL 32073-5571 Ph: (904) 278-0016 |
| NPI Number | 1790793016 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 11/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790793016 | NPI | - | NPPES |
| 7388361 | Other | FL | AETNA |
| 01528 | Other | FL | BLUE CROSS BLUE SHIELD |
| 6965204 | Other | FL | CIGNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME81222 (Florida) | Primary |
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