Primary Physician Resource, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PRIMARY PHYSICIAN RESOURCE, LLC

Practice address

330 SW 27TH Ave Ste 403B
Miami, FL 33135-2967

Phone

(786) 348-2589

NPI assigned

Apr 24, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristiane Villalvazo-Gonzalez

Title

Managing Member

Phone

(786) 348-2589

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melkis Martinez Casas

  • Family Nurse Practitioner
  • Miami, FL
  • NPI 1487405692
  Medicare reassignment NPD
• Edward Gonzalez, D.P.M,

  • Podiatrist
  • Miami, FL
  • NPI 1912217936
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1003504531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430764",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332430764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SW 27TH AVE STE 403B",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352967",
            "telephone_number": "786-348-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY PHYSICIAN RESOURCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "VILLALVAZO-GONZALEZ",
        "authorized_official_first_name": "KRISTIANE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "786-348-2589"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Medical Care Inc
• Primary Pharmacy, Inc.
• Primary Plus Medical Ctr Inc
• Primary Provider Inc.
• Primary Wound Care Specialists LLC
• Primavera Adult Day Care Inc
• Primavera Alf LLC

• Primary Care Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.