Organization
PRIME CARE MEDICAL CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID R THOMSEN (OWNER)
(863) 294-3109
Entity
Organization
Contact information
Practice address
1400 HAVENDALE BLVD NW STE 3, WINTER HAVEN, FL 33881-5302
(863) 294-3109
(863) 293-0078
Mailing address
1400 HAVENDALE BLVD NW STE 3, WINTER HAVEN, FL 33881-5302
(863) 294-3109
(863) 293-0078
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
02/17/2016
Last updated
08/17/2016
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