Organization
CENTERWELL SENIOR PRIMARY CARE (LA) PC
Active
Other names
CenterWell Senior Primary Care-Covington
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
66 PARK PLACE DR, COVINGTON, LA 70433-5183
(985) 875-5459
(877) 872-3840
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
04/26/2021
Last updated
08/22/2024
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