Organization
CENTERWELL SENIOR PRIMARY CARE (NV) PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (NV) PC
Other names
CenterWell Senior Primary Care-Rancho
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
3860 W LAKE MEAD BLVD STE 100, NORTH LAS VEGAS, NV 89032-5203
(702) 673-5471
(888) 481-1462
Mailing address
4700 MILLENIA BLVD STE 650, ORLANDO, FL 32839-6013
(407) 447-7120
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
Enumeration date
09/27/2023
Last updated
02/15/2024
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