Organization
CENTERWELL SENIOR PRIMARY CARE VITALITY INC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE VITALITY INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE VITALITY INC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
2955 BROWNWOOD BLVD STE 403, THE VILLAGES, FL 32163-2040
(352) 674-8700
(352) 674-8714
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(407) 447-7120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
09/19/2025
Last updated
09/19/2025
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