Organization
FIRST HARBOUR MEDICAL CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELA WATTERS (DIRECTOR OF COMPLIANCE)
(941) 243-4660
Entity
Organization
Contact information
Practice address
712 53RD AVE E, BRADENTON, FL 34203-5827
(941) 755-2456
Mailing address
7320 DELAINEY CT, LAKEWOOD RANCH, FL 34240-8445
(941) 373-6323
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Enumeration date
04/14/2016
Last updated
03/17/2018
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