Provider Demographics
NPI:1831986983
Name:DR. G'S PRIMARY CARE
Entity type:Organization
Organization Name:DR. G'S PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEGUERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-715-0336
Mailing Address - Street 1:1425 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6384
Mailing Address - Country:US
Mailing Address - Phone:561-330-9363
Mailing Address - Fax:561-274-1930
Practice Address - Street 1:1425 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6384
Practice Address - Country:US
Practice Address - Phone:561-330-9363
Practice Address - Fax:561-274-1930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty