Organization
CENTERWELL SENIOR PRIMARY CARE (LA) PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (LA) PC
Other names
CenterWell Senior Primary Care LA PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE (LA) PC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
4101 S CARROLLTON AVE, NEW ORLEANS, LA 70119-6817
(407) 447-7120
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
11/09/2023
Last updated
08/22/2024
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