| Primary Care Of Gainesville Llc | |
|
1026 Sw 2nd Ave Ste C Gainesville FL 32601-8182 | |
| (352) 505-0255 | |
| (352) 505-0997 |
| Full Name | Primary Care Of Gainesville Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1026 Sw 2nd Ave Ste C, Gainesville, Florida |
| Authorized Official Name and Position | Ernesto J Lamadrid (PRESIDENT) |
| Authorized Official Contact | 3525050255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Of Gainesville Llc 1026 Sw 2nd Ave Ste C Gainesville FL 32601-8182 Ph: (352) 505-0255 | Primary Care Of Gainesville Llc 1026 Sw 2nd Ave Ste C Gainesville FL 32601-8182 Ph: (352) 505-0255 |
| NPI Number | 1558606335 |
|---|---|
| Provider Enumeration Date | 12/04/2012 |
| Last Update Date | 02/15/2013 |
| Medicare PECOS PAC ID | 2860636362 |
|---|---|
| Medicare Enrollment ID | O20130924000463 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558606335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ACN101 (Florida) | Primary |
| Provider Name | Ernesto J Lamadrid |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578777140 PECOS PAC ID: 7810064706 Enrollment ID: I20080918000140 |
| Provider Name | John D. Colon |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1477665339 PECOS PAC ID: 6507059300 Enrollment ID: I20101026000027 |
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