Provider Demographics
NPI:1366676355
Name:WEST PRIMARY CARE LLC
Entity Type:Organization
Organization Name:WEST PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-767-5716
Mailing Address - Street 1:8395 W. OAKLAND PARK BLVD.
Mailing Address - Street 2:SUITE E
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-2550
Mailing Address - Country:US
Mailing Address - Phone:954-741-7500
Mailing Address - Fax:954-741-7330
Practice Address - Street 1:THREE MARYLAND FARMS
Practice Address - Street 2:SUITE 250
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5053
Practice Address - Country:US
Practice Address - Phone:800-661-3364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10184207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty