Basic Information
| Provider Information | |||||||||
| NPI: | 1437334323 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL FLORIDA PRIMARY PHYSICIANS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1565 SAXON BLVD STE 103 | ||||||||
| Address2: | |||||||||
| City: | DELTONA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3865741423 | ||||||||
| FaxNumber: | 3216845212 | ||||||||
| Practice Location | |||||||||
| Address1: | 1565 SAXON BLVD STE 103 | ||||||||
| Address2: | |||||||||
| City: | DELTONA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3865741423 | ||||||||
| FaxNumber: | 3216845212 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2008 | ||||||||
| LastUpdateDate: | 01/07/2022 | ||||||||
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| AuthorizedOfficialLastName: | SUAREZ | ||||||||
| AuthorizedOfficialFirstName: | CLAUDIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3865741423 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.