Provider Demographics
NPI:1093596439
Name:TESAR PRIMECARE, LLC
Entity Type:Organization
Organization Name:TESAR PRIMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:TESAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-726-5220
Mailing Address - Street 1:6643 38TH LN E
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-7962
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6643 38TH LN E
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-7962
Practice Address - Country:US
Practice Address - Phone:941-726-5220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIMECARE VENICE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty