Provider Demographics
NPI:1245726652
Name:ANCHOR DIRECT PRIMARY CARE, LLC
Entity type:Organization
Organization Name:ANCHOR DIRECT PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:RENSBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:407-634-1690
Mailing Address - Street 1:1850 LEE RD STE 134
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2104
Mailing Address - Country:US
Mailing Address - Phone:407-634-1690
Mailing Address - Fax:407-369-4236
Practice Address - Street 1:1850 LEE RD STE 134
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2104
Practice Address - Country:US
Practice Address - Phone:407-634-1690
Practice Address - Fax:407-369-4236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care