Organization
CENTERWELL SENIOR PRIMARY CARE NC JV PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE NC JV PC
Other names
CenterWell Senior Primary Care-University City
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE NC JV PC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
8727 JW CLAY BLVD, CHARLOTTE, NC 28262-5417
(980) 999-1831
(877) 536-8312
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(980) 999-1831
(877) 536-8312
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Enumeration date
06/01/2022
Last updated
02/11/2025
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