Washington Hills Primary Care Llc | |
4645 Plantation Oaks Blvd Orange Park FL 32065-3652 | |
(904) 505-7566 | |
Not Available |
Full Name | Washington Hills Primary Care Llc |
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Speciality | Clinic/Center |
Location | 4645 Plantation Oaks Blvd, Orange Park, Florida |
Authorized Official Name and Position | Regina Imari Washington (NURSE PRACTITIONER) |
Authorized Official Contact | 9045057566 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Washington Hills Primary Care Llc 4645 Plantation Oaks Blvd Orange Park FL 32065-3652 Ph: (904) 505-7566 | Washington Hills Primary Care Llc 4645 Plantation Oaks Blvd Orange Park FL 32065-3652 Ph: (904) 505-7566 |
NPI Number | 1205441615 |
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Provider Enumeration Date | 09/11/2020 |
Last Update Date | 03/19/2021 |
Medicare PECOS PAC ID | 1850708819 |
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Medicare Enrollment ID | O20210318002638 |
Identifier | Type | State | Issuer |
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1205441615 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Regina I Washington |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083816946 PECOS PAC ID: 3173501319 Enrollment ID: I20150527002043 |
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