Organization
CENTERWELL SENIOR PRIMARY CARE GA PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE GA PC
Other names
CenterWell Senior Primary Care- Grove Park
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE GA PC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
2056 DONALD LEE HOLLOWELL PKWY NW STE 1, ATLANTA, GA 30318-4764
(470) 890-3910
(877) 445-5270
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(305) 500-2000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
11/05/2021
Last updated
07/03/2024
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