Organization
CENTERWELL SENIOR PRIMARY CARE (MO) PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (MO) PC
Other names
CenterWell Senior Primary Care- Gladstone
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE (MO) PC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
7209 N PROSPECT AVE., GLADSTONE, MO 64119-5351
(816) 429-1396
(816) 256-4168
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(407) 447-7120
(407) 770-0661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
09/26/2024
Last updated
01/09/2025
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