Provider Type Icon

PRIMECARE MEDICAL CLINIC PA NPI 1861688814


NPI Information

NPI: 1861688814
Provider Name: PRIMECARE MEDICAL CLINIC, PA
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D0941231

Address:
2869 WILSHIRE DR
SUITE 205
ORLANDO, FL
ZIP 32835
Phone: (407) 295-0500
Get Directions

PRIMECARE MEDICAL CLINIC, PA is a family medicine in Orlando, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PRIMECARE MEDICAL CLINIC, PA NPI is 1861688814. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2869 WILSHIRE DR
SUITE 205
ORLANDO, FL
ZIP 32835-282
Phone: (407) 295-0500
Fax: (407) 290-2997

The provider's authorized official is Mohammed Ak Moosa .
The authorized official title is President and has the following contact phone number (407) 830-5080.

The CLIA number assigned to this NPI record is 10D0941231 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/23/2007 and was last updated on 5/6/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineME73277FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
142524AOTHERFLORIDAINDIVIDUAL MC PROVIDER #
2F82588MEDICARE UPINFLORIDA
3K2454MEDICARE PINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.