Primecare at Twin Lakes LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

10698 Issued in FL

Legal business name

PRIMECARE AT TWIN LAKES LLC

Doing business as

PrimeCare Urgent Care Centers
PrimeCare at Port Orange

Practice address

1327 Saxon Dr
New Smyrna Beach, FL 32169-3160

Phone

(386) 767-2402

Fax

(386) 767-1566

NPI assigned

Aug 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Lisa D Lehman, MD

Title

President

Phone

(386) 274-2212

Specialties & licenses 1

Addresses

Other names 2

• PrimeCare Urgent Care Centers Doing business as
• PrimeCare at Port Orange Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Primecare at Port Orange2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Primecare at Twin Lakes LLC

  • Urgent Care Clinic/Center
  • Daytona Beach, FL
  • NPI 1154601706
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Buckley Canalizo, MD

  • Emergency Medicine Physician
  • Orange City, FL
  • NPI 1538116355
  NPD (past)

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1104072594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD",
            "address_2": "SUITE 130",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177130",
            "telephone_number": "386-274-2212",
            "fax_number": "386-274-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 SAXON DR",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321693160",
            "telephone_number": "386-767-2402",
            "fax_number": "386-767-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE AT TWIN LAKES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "LEHMAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-274-2212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "10698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrimeCare Urgent Care Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PrimeCare at Port Orange",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard M Pratt III, ARNP
• PRC Associates, LLC
• Preferred Injury Physicians of New Smyrna Beach, Inc
• Kimberly Prieto, RBT
• Prime Love & Care Assisted Living LLC (Coquina Cay ALF)
• Ashley Probasco, APRN
• John A Prodoehl, M.D.
• Amanda Joy Prokop, DC
• Daniel Joseph Prugar, DC
• Publix Super Markets Inc (Publix Pharmacy #1649)

• Urgent Care Clinic/Center in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Urgent Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.