Dynamic Primary Healthcare Clinic
Doing business as Dynamic Primary Healthcare Clinic Inc
Rural health clinic in Lake City, FL, Medicare certification number 103964.
Medicare certification
Provider of Services- CCN
- 103964
- Status
- Active
- Provider type
- Rural health clinic
- Control type
- For profit – corporation
- Participating since
- May 17, 2012
- Last certification
- Feb 25, 2025
- Address
- 163 SW Stonegate Ter Ste 109
Lake City, FL 32024
(386) 438-8391
NPI records for this facility (CCN to NPI Mapping) 1
-
- Family Medicine Physician
- Lake City, FL
- NPI 1710633144
Medicare enrollment
Sources for this page
- Provider of Services: the certification, provider type, beds and status.
- Medicare Care Compare: the star rating and every measure on this page, with the state and national rates CMS publishes beside them.
- NPPES NPI Registry: the NPI records connected to this certification.