PRIMARY CARE 369 LLC NPI 1760034300

NPI Information

PRIMARY CARE 369 LLC is a primary care clinic center in Boca Raton, FL. PRIMARY CARE 369 LLC NPI is 1760034300. The provider is registered as an organization entity type.

The provider's business location address is:

9980 CENTRAL PARK BLVD N STE 314
BOCA RATON, FL
ZIP 33428-704
Phone: (561) 315-0198

The provider's authorized official is Gayatri Siram .
The authorized official title is Owner and has the following contact phone number (561) 315-0198.

The CLIA number assigned to this NPI record is 10D2174292 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/14/2019 and was last updated on 12/5/2019.

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:

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