Organization
PRIMECARE FAMILY MEDICAL CENTERS OSCEOLA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENE CASANOVA MD (OWNER/PRESIDENT)
(305) 442-1740
Entity
Organization
Contact information
Practice address
217 E OAK ST, KISSIMMEE, FL 34744-4503
(407) 988-1035
(407) 988-1034
Mailing address
7765 NW 48TH ST STE 300, DORAL, FL 33166-5404
(305) 442-1740
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME78770
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264910101
—
FL
Enumeration date
01/09/2018
Last updated
01/09/2018
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