Organization
CENTERWELL SENIOR PRIMARY CARE NC JV PC
Active
Parent organization
CENTERWELL SENIOR PRIMARY CARE NC JV PC
Other names
CenterWell Senior Primary Care NC PC, CenterWell Senior Primary Care- Wilkinson
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTERWELL SENIOR PRIMARY CARE NC JV PC
Authorized official
ANGIE MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
3512 WILKINSON BLVD STE 130, CHARLOTTE, NC 28208-5698
(980) 999-2964
(877) 691-5325
Mailing address
4700 MILLENIA BLVD STE 650, ORLANDO, FL 32839-6013
(407) 447-7120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
05/13/2022
Last updated
01/09/2023
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