Primecare Acquisition Family Practice Inc | |
1890 Lpga Blvd Ste 130 Daytona Beach FL 32117-7131 | |
(386) 274-2212 | |
(386) 274-1508 |
Full Name | Primecare Acquisition Family Practice Inc |
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Speciality | Family Medicine |
Location | 1890 Lpga Blvd Ste 130, Daytona Beach, Florida |
Authorized Official Name and Position | Lisa M Lehman (DIRECTOR) |
Authorized Official Contact | 3862742212 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primecare Acquisition Family Practice Inc 1890 Lpga Blvd Ste 130 Daytona Beach FL 32117-7131 Ph: (386) 274-2212 | Primecare Acquisition Family Practice Inc 1890 Lpga Blvd Ste 130 Daytona Beach FL 32117-7131 Ph: (386) 274-2212 |
NPI Number | 1003452681 |
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Provider Enumeration Date | 11/19/2019 |
Last Update Date | 03/21/2022 |
Medicare PECOS PAC ID | 5799116315 |
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Medicare Enrollment ID | O20200515000882 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003452681 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | John B Canalizo |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538116355 PECOS PAC ID: 9234235417 Enrollment ID: I20090619000481 |
Provider Name | Monica E Cantu |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1598155830 PECOS PAC ID: 5698091940 Enrollment ID: I20150303001644 |
Provider Name | Rebecca A Romack |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619234770 PECOS PAC ID: 1658670252 Enrollment ID: I20171006000661 |
Provider Name | Regina M George |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477079036 PECOS PAC ID: 0345515516 Enrollment ID: I20171014000260 |
Provider Name | Coman Thomas |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447622600 PECOS PAC ID: 2567765225 Enrollment ID: I20220630000814 |
Provider Name | Tammy Jo Leggett |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871066373 PECOS PAC ID: 1658723697 Enrollment ID: I20240116001581 |
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