Primary Total Care Corp | |
3015 S Congress Ave Ste 1 Lake Worth FL 33461-2111 | |
(561) 308-0818 | |
(561) 444-3491 |
Full Name | Primary Total Care Corp |
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Speciality | Family Medicine |
Location | 3015 S Congress Ave Ste 1, Lake Worth, Florida |
Authorized Official Name and Position | Marlenys Perez (MANAGER) |
Authorized Official Contact | 5613080818 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Total Care Corp 3015 S Congress Ave Ste 1 Lake Worth FL 33461-2111 Ph: (561) 308-0818 | Primary Total Care Corp 3015 S Congress Ave Ste 1 Lake Worth FL 33461-2111 Ph: (561) 308-0818 |
NPI Number | 1982218079 |
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Provider Enumeration Date | 09/04/2020 |
Last Update Date | 09/04/2020 |
Medicare PECOS PAC ID | 0840600292 |
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Medicare Enrollment ID | O20201113001137 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982218079 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Meibol Mas San Juan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528686250 PECOS PAC ID: 7618387291 Enrollment ID: I20201110003302 |
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