Provider Demographics
NPI:1013004431
Name:PRIMECARE OF CORAL GABLES,PA
Entity Type:Organization
Organization Name:PRIMECARE OF CORAL GABLES,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-443-3001
Mailing Address - Street 1:299 ALHAMBRA CIR
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5106
Mailing Address - Country:US
Mailing Address - Phone:305-443-3001
Mailing Address - Fax:305-441-9427
Practice Address - Street 1:299 ALHAMBRA CIR
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5106
Practice Address - Country:US
Practice Address - Phone:305-443-3001
Practice Address - Fax:305-441-9427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty