Organization
CENTERWELL SENIOR PRIMARY CARE IL CS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE S MARTINEZ (SENIOR CREDENTIALING PROFESSIONAL)
(407) 447-7120
Entity
Organization
Contact information
Practice address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(407) 447-7120
(407) 770-0661
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(407) 447-7120
(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
08/05/2025
Last updated
08/05/2025
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