Organization
CENTERWELL SENIOR PRIMARY CARE (NV) PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (NV) PC
Other names
Partners in Primary Care-Fremont Street, CenterWell Senior Primary Care -Fremont Street, Partners in Primary Care NV PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE (NV) PC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
1766 E CHARLESTON BLVD, LAS VEGAS, NV 89104-1945
(702) 843-2440
(833) 749-0349
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
—
—
207RI0011X
Interventional Cardiology Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250009773
—
NV
Enumeration date
05/20/2020
Last updated
07/03/2024
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