Organization
PRIMACARE HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY HAUGHTON (OFFICE MANAGER)
(727) 823-4848
Entity
Organization
Contact information
Practice address
5800 49TH AVE N STE S103, KENNETH CITY, FL 33709-3563
(727) 823-4848
(727) 823-4880
Mailing address
5800 49TH AVE N STE S103, KENNETH CITY, FL 33709-3563
(727) 823-4848
(727) 823-4880
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528064797
NPI
FL
Enumeration date
04/02/2024
Last updated
04/02/2024
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