Provider Demographics
NPI:1083989438
Name:PRIMARY CARE PROVIDERS INC
Entity Type:Organization
Organization Name:PRIMARY CARE PROVIDERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STRUVE-DOERFLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:352-816-1800
Mailing Address - Street 1:1202 SW 17TH ST SUITE 201
Mailing Address - Street 2:BOX 168
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-1283
Mailing Address - Country:US
Mailing Address - Phone:352-237-4877
Mailing Address - Fax:352-237-4880
Practice Address - Street 1:635 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4428
Practice Address - Country:US
Practice Address - Phone:352-237-4877
Practice Address - Fax:352-237-4880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
FLARNP663102363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty