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Organization
PRIMARY CARE SPECIALISTS, LLC
Active
Organization
PRIMARY CARE SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD J KIVETT MD (PARTNER)
(407) 275-9014
Entity
Organization
Contact information
Practice address
2572 W STATE ROAD 426, SUITE 1040, OVIEDO, FL 32765-8389
(407) 366-9800
(407) 366-9283
Mailing address
2572 WEST ST RD 426 SUITE 1040, OVIEDO, FL 32765
(407) 366-9800
(407) 366-9283
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207Q00000X
FAMILY PRACTICE
FL
01
—
24506
BCBS
FL
01
—
363L00000X
NURSE PRACTITIONER
FL
Enumeration date
10/02/2006
Last updated
06/15/2011
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