Provider Demographics
NPI:1578455200
Name:FLORENCE PRIMARY CARE
Entity type:Organization
Organization Name:FLORENCE PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:NEELIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DACHURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-371-1257
Mailing Address - Street 1:4155 S LEE ST STE B100
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-3649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4155 S LEE ST STE B100
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3649
Practice Address - Country:US
Practice Address - Phone:678-371-1257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty