Organization
CENTERWELL SENIOR PRIMARY CARE FL INC.
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE FL INC.
Other names
CenterWell Senior Primary Care of Southchase
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
12402 S ORANGE BLOSSOM TRL STE 6, ORLANDO, FL 32837-6539
(407) 541-0114
Mailing address
4700 MILLENIA BLVD STE 650, ORLANDO, FL 32839-6013
(407) 447-7120
(407) 770-0661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
01/23/2024
Last updated
05/10/2024
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