Organization
LIFETIME MEDICAL CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIDAL EL RIMAWI M.D. (PRESIDENT)
(904) 278-0016
Entity
Organization
Contact information
Practice address
2300 PARK AVE, SUITE 203, ORANGE PARK, FL 32073-5571
(904) 278-0016
(904) 278-4217
Mailing address
5000 US HIGHWAY 17, SUITE 18-302, ORANGE PARK, FL 32003-8231
(904) 278-0016
(904) 278-4217
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME81222
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01528
BLUE CROSS BLUE SHIELD
FL
01
—
6965204
CIGNA
FL
01
—
7388361
AETNA
FL
Enumeration date
08/03/2006
Last updated
11/06/2008
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