Organization
CENTERWELL SENIOR PRIMARY CARE KY PSC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE KY PSC
Other names
CenterWell Senior Primary Care- Regency center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE KY PSC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
171 W LOWRY LN STE 180, LEXINGTON, KY 40503-3006
(859) 334-1550
(877) 471-2996
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
12/21/2022
Last updated
08/22/2024
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