Provider Demographics
NPI:1861087744
Name:INTERNAL MEDICINE PRIME CARE LLC
Entity type:Organization
Organization Name:INTERNAL MEDICINE PRIME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CUADRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-366-7771
Mailing Address - Street 1:8927 HYPOLUXO RD. STE A3
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467
Mailing Address - Country:US
Mailing Address - Phone:561-366-7771
Mailing Address - Fax:561-855-2718
Practice Address - Street 1:8927 HYPOLUXO RD. STE A3
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467
Practice Address - Country:US
Practice Address - Phone:561-366-7771
Practice Address - Fax:561-855-2718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care