Provider Demographics
NPI:1457697245
Name:PRIMARY MEDICAL CARE CENTER AND URGENT CAE CLINIC, INC
Entity Type:Organization
Organization Name:PRIMARY MEDICAL CARE CENTER AND URGENT CAE CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PRINSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN GLAUDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-345-1369
Mailing Address - Street 1:11010 SW 88TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1216
Mailing Address - Country:US
Mailing Address - Phone:305-345-1369
Mailing Address - Fax:305-921-9096
Practice Address - Street 1:11010 SW 88TH ST
Practice Address - Street 2:STE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1216
Practice Address - Country:US
Practice Address - Phone:305-345-1369
Practice Address - Fax:305-921-9096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-24
Last Update Date:2012-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care