Provider Demographics
NPI:1881941821
Name:AIKEN'S PRIMARY CARE LLC
Entity type:Organization
Organization Name:AIKEN'S PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:AIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-510-6485
Mailing Address - Street 1:5975 W SUNRISE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-6801
Mailing Address - Country:US
Mailing Address - Phone:954-607-8770
Mailing Address - Fax:954-792-6789
Practice Address - Street 1:5975 W SUNRISE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-6801
Practice Address - Country:US
Practice Address - Phone:954-607-8770
Practice Address - Fax:954-792-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106460261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care