Provider Demographics
NPI:1689392011
Name:ASPIRE DIRECT PRIMARY CARE, PLLC
Entity Type:Organization
Organization Name:ASPIRE DIRECT PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-657-7976
Mailing Address - Street 1:1955 MESIC HAMMOCK WAY
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-4155
Mailing Address - Country:US
Mailing Address - Phone:418-001-6309
Mailing Address - Fax:941-800-1631
Practice Address - Street 1:415 COMMERCIAL CT STE C
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1654
Practice Address - Country:US
Practice Address - Phone:941-800-1630
Practice Address - Fax:941-800-1631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty