Organization
CENTERWELL SENIOR PRIMARY CARE (FL) INC.
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (FL) INC.
Other names
CenterWell Senior Primary Care of Lake Underhill, Family Physicians of Winter Park PA, Family Physicians of Winter Park Inc, Family Physicians of Lake Underhill
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE (FL) INC.
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
11242 E COLONIAL DR, ORLANDO, FL 32817-4537
(407) 273-7373
(407) 770-0675
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
—
FL
207R00000X
Internal Medicine Physician
Primary
—
FL
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025017715
—
FL
Enumeration date
11/07/2006
Last updated
12/09/2024
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