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Organization
PRIMECARE MEDICAL GROUP LLC
Active
Organization
PRIMECARE MEDICAL GROUP LLC
Active
Other names
Primecare Medical of Land o Lakes
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN REVELLO (PRESIDENT)
(813) 932-0996
Entity
Organization
Contact information
Practice address
2638 NARNIA WAY UNIT 101, LAND O LAKES, FL 34638-7321
(813) 909-0760
(813) 949-7394
Mailing address
2638 NARNIA WAY UNIT 101, LAND O LAKES, FL 34638-7321
(813) 909-0760
(813) 949-7394
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME80045
FL
Other
Enumeration date
07/23/2009
Last updated
05/03/2010
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