| Primary One Healthcare Pllc | |
|
433 Plaza Real Ste 275 Boca Raton FL 33432-3999 | |
| (561) 332-4545 | |
| (888) 726-9869 |
| Full Name | Primary One Healthcare Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 433 Plaza Real Ste 275, Boca Raton, Florida |
| Authorized Official Name and Position | Vicky Paul (CO-OWNER) |
| Authorized Official Contact | 5613324545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary One Healthcare Pllc 433 Plaza Real Ste 275 Boca Raton FL 33432-3999 Ph: (561) 332-4545 | Primary One Healthcare Pllc 433 Plaza Real Ste 275 Boca Raton FL 33432-3999 Ph: (561) 332-4545 |
| NPI Number | 1922753508 |
|---|---|
| Provider Enumeration Date | 02/13/2022 |
| Last Update Date | 02/15/2022 |
| Medicare PECOS PAC ID | 0941697981 |
|---|---|
| Medicare Enrollment ID | O20220421002444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922753508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Vicky Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821479817 PECOS PAC ID: 5193094019 Enrollment ID: I20170922000838 |
| Provider Name | Rollin Cenatus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649738113 PECOS PAC ID: 6507265089 Enrollment ID: I20210603001754 |
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