West Coast Primary Care, Llc | |
8250 Bryan Dairy Rd Suite 305 Largo FL 33777-1353 | |
(727) 391-5008 | |
(727) 938-1481 |
Full Name | West Coast Primary Care, Llc |
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Speciality | Family Medicine |
Location | 8250 Bryan Dairy Rd, Largo, Florida |
Authorized Official Name and Position | Giovanni Baula (PRESIDENT) |
Authorized Official Contact | 7278248270 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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West Coast Primary Care, Llc 8250 Bryan Dairy Rd Suite 305 Largo FL 33777-1353 Ph: (727) 391-5008 | West Coast Primary Care, Llc 8250 Bryan Dairy Rd Suite 305 Largo FL 33777-1353 Ph: (727) 391-5008 |
NPI Number | 1528327087 |
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Provider Enumeration Date | 05/03/2012 |
Last Update Date | 05/03/2012 |
Medicare PECOS PAC ID | 6709041585 |
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Medicare Enrollment ID | O20120628000371 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528327087 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Provider Name | Eduardo H Martinez |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1417955337 PECOS PAC ID: 5597867697 Enrollment ID: I20070220000567 |
Provider Name | Karen L Johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417090523 PECOS PAC ID: 7416045117 Enrollment ID: I20071114000018 |
Provider Name | Colin Chan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194710871 PECOS PAC ID: 0749474278 Enrollment ID: I20101028001326 |
Provider Name | Va Im |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396010229 PECOS PAC ID: 4284866427 Enrollment ID: I20140422001406 |
Provider Name | Therese M Grandlienard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568822716 PECOS PAC ID: 0749617439 Enrollment ID: I20200219000725 |
Provider Name | Jason D Philippe |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982165775 PECOS PAC ID: 4284068578 Enrollment ID: I20220127002257 |
Provider Name | Lorin A Carroll |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548943830 PECOS PAC ID: 8325494818 Enrollment ID: I20231019000460 |
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