Provider Demographics
NPI:1245525518
Name:QUALITY PRIMARY CARE P A
Entity type:Organization
Organization Name:QUALITY PRIMARY CARE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DODARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-854-7911
Mailing Address - Street 1:11048-9 BAYMEADOWS ROAD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:904-854-7911
Mailing Address - Fax:904-854-7912
Practice Address - Street 1:11048 BAYMEADOWS RD
Practice Address - Street 2:STE 9
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9699
Practice Address - Country:US
Practice Address - Phone:904-854-7911
Practice Address - Fax:904-854-7912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-15
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP10000084848261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care