| North Florida Primary Care Pllc | |
|
221 Sw Stonegate Ter Ste 101 Lake City FL 32024-3463 | |
| (386) 292-7744 | |
| Not Available |
| Full Name | North Florida Primary Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 221 Sw Stonegate Ter Ste 101, Lake City, Florida |
| Authorized Official Name and Position | Michael C Ukaegbu (OWNER) |
| Authorized Official Contact | 3866974973 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Florida Primary Care Pllc 221 Sw Stonegate Ter Ste 101 Lake City FL 32024-3463 Ph: (386) 292-7744 | North Florida Primary Care Pllc 221 Sw Stonegate Ter Ste 101 Lake City FL 32024-3463 Ph: (386) 292-7744 |
| NPI Number | 1760093702 |
|---|---|
| Provider Enumeration Date | 08/13/2020 |
| Last Update Date | 12/09/2020 |
| Medicare PECOS PAC ID | 3678985017 |
|---|---|
| Medicare Enrollment ID | O20201209001242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760093702 | NPI | - | NPPES |
| 010767000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Ukaegbu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427254283 PECOS PAC ID: 1052592128 Enrollment ID: I20140801001019 |
| Provider Name | Krista M Lowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407481930 PECOS PAC ID: 8921410713 Enrollment ID: I20201221000773 |
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