Organization
CENTERWELL SENIOR PRIMARY CARE (SC) JV PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE (SC) JV PC
Other names
CenterWell Senior Primary Care-International Drive
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE (SC) JV PC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
310 HINSON DR STE 3, MYRTLE BEACH, SC 29579-4435
(843) 966-0613
(843) 628-0979
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
12/17/2024
Last updated
01/06/2026
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