Organization
FLORIDA PRIMARY CARE AND SPORTS MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN SHAW (ADMINISTRATOR)
(386) 447-6615
Entity
Organization
Contact information
Practice address
140 PINNACLES DR, PALM COAST, FL 32164-2322
(386) 597-2829
(386) 313-1923
Mailing address
6 OFFICE PARK DR, PALM COAST, FL 32137-3808
(386) 447-6615
(386) 447-1266
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
09/10/2019
Last updated
07/01/2025
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