Provider Demographics
NPI:1184356354
Name:ASPIRE PRIMARY CARE
Entity type:Organization
Organization Name:ASPIRE PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NEYSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-618-2121
Mailing Address - Street 1:10570 SW CAPRAIA WAY
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2885
Mailing Address - Country:US
Mailing Address - Phone:772-618-2121
Mailing Address - Fax:
Practice Address - Street 1:1715 SE TIFFANY AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7511
Practice Address - Country:US
Practice Address - Phone:772-618-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center