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Organization
PRIMECARE LAKE NONA, LLC
Active
Organization
PRIMECARE LAKE NONA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JAIME DANIELS (CEO)
(407) 846-8180
Entity
Organization
Contact information
Practice address
10437 MOSS PARK RD, ORLANDO, FL 32832-5812
(407) 846-8180
(407) 347-4858
Mailing address
222 BROADWAY, SUITE 302, KISSIMMEE, FL 34741
(407) 846-8180
(407) 347-4858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME36463
FL
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
05/04/2011
Last updated
06/20/2018
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