Organization
PRIMARY CARE 369 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAYATRI SIRAM MD (OWNER)
(561) 315-0198
Entity
Organization
Contact information
Practice address
9980 CENTRAL PARK BLVD N STE 314, BOCA RATON, FL 33428-1704
(561) 315-0198
Mailing address
8990 LAKEVIEW PL, PARKLAND, FL 33076-4122
(954) 801-5172
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/14/2019
Last updated
12/05/2019
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