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MARINER PRIMECARE MEDICAL CENTER LLC NPI 1316192867


NPI Information

NPI: 1316192867
Provider Name: MARINER PRIMECARE MEDICAL CENTER LLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
7056 MARINER BLVD
SPRING HILL, FL
ZIP 34609
Phone: (352) 597-5557
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MARINER PRIMECARE MEDICAL CENTER LLC is a general practice in Spring Hill, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MARINER PRIMECARE MEDICAL CENTER LLC NPI is 1316192867. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7056 MARINER BLVD
SPRING HILL, FL
ZIP 34609-000
Phone: (352) 597-5557
Fax: (352) 597-0552

The provider's authorized official is Martin Revello .
The authorized official title is President and has the following contact phone number (813) 514-6750.

The enumeration date for this NPI number is 11/25/2008 and was last updated on 11/25/2008.


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
1208D00000XGeneral PracticeME83175FLORIDAYes

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
1E5540MEDICARE 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: 4/28/2024

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