Primecare at Twin Lakes LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

10699 Issued in FL

Legal business name

PRIMECARE AT TWIN LAKES LLC

Practice address

1890 Lpga Blvd
Suite 130
Daytona Beach, FL 32117-7130

Phone

(386) 274-2212

Fax

(386) 274-1508

NPI assigned

Aug 26, 2011

Organization subpart

No

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

Authorized official

Name

Charles D Duva, MD

Title

President

Phone

(386) 274-7800

Specialties & licenses 1

Addresses

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
  • New Smyrna Beach, FL
  • NPI 1104072594
  NPD tax ID

Locations

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1154601706",
    "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": "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE AT TWIN LAKES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "DUVA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-274-7800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "10699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah-Elisabeth Priest
• Primary Healthcare Alliance Foundation Inc
• Prime Health of Central Florida
• Primecare Acquisition Family Practice Inc
• Primecare Acquisition Inc
• Primecare at Twin Lakes LLC
• Primecare Family Medicine LLC
• Fay L Prince, RN
• Leeanne Pringle, MS, CCC-SLP
• Professional Radiology Associates PA

• Urgent Care Clinic/Center in Daytona Beach, FL
• Providers in Daytona 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 Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.