PRIMECARE AT TWIN LAKES LLC NPI 1902809122

NPI Information

NPI: 1902809122
Provider Name: PRIMECARE AT TWIN LAKES LLC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

Address:
1890 LPGA BLVD
STE 130
DAYTONA BEACH, FL
ZIP 32117
Phone: (386) 274-2212
Get Directions

PRIMECARE AT TWIN LAKES LLC is an urgent care clinic center in Daytona Beach, FL. PRIMECARE AT TWIN LAKES LLC NPI is 1902809122. The provider is registered as an organization entity type.

The provider's business location address is:

1890 LPGA BLVD
STE 130
DAYTONA BEACH, FL
ZIP 32117-130
Phone: (386) 274-2212
Fax: (386) 274-1508

The provider's authorized official is Charles Duva .
The authorized official title is President and has the following contact phone number (386) 274-7800.

The enumeration date for this NPI number is 5/23/2005 and was last updated on 5/6/2011.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QU0200X	Clinic/Center	Urgent Care	ME47294	FLORIDA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DC0901	OTHER	FLORIDA	RAILROAD MEDICARE GROUP
2	5660340001	MEDICARE NSC	FLORIDA
3	77984	OTHER	FLORIDA	BC/BS OF FL PA GROUP
4	K5814	MEDICARE PIN	FLORIDA

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

NPI Synchronization or Removal

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