Organization
PRIMERA CHOICE URGENT CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FEMI OGUNFOWOKAN (MGRM)
(407) 936-4635
Entity
Organization
Contact information
Practice address
3861 AVALON PARK EAST BLVD, ORLANDO, FL 32828-4853
(407) 378-5300
(407) 378-5360
Mailing address
3861 AVALON PARK EAST BLVD, ORLANDO, FL 32828-4853
(407) 378-5300
(407) 378-5360
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GH092A
CMS-MEDICARE
FL
Enumeration date
04/27/2012
Last updated
09/19/2012
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