Centerwell Senior Primary Care Ga PC

Organization Active NPI Internal Medicine Physician · Miami, FL

NPI 1336713700 · NPPES record last updated Dec 17, 2024

Key facts

NPI
1336713700
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
CENTERWELL SENIOR PRIMARY CARE GA PC
Practice address
6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone
(407) 447-7120
Fax
(407) 770-0661
NPI assigned
May 19, 2021
Organization subpart
No

Authorized official

Name
Angie Martinez
Title
Senior Credentialing Professional
Phone
(407) 447-7120

Corporate family (same tax ID) 12

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

Practitioners 34

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

View all 34

National Provider Directory

Tax ID family
Centerwell Senior Primary Care Ga PC (13 organizations share this tax ID)

Locations

3030 Headland Dr SW
Atlanta, GA 30311
Phone (404) 344-5383

3571 Martin Luther King Jr Dr SW
Atlanta, GA 30331
Phone (470) 832-6550

2389 Wesley Chapel Rd
Ste 102
Decatur, GA 30035
Phone (404) 469-9867

210 Cobb Pkwy S
#100
Marietta, GA 30060
Phone (678) 941-6245

5234 Memorial Dr
Stone Mountain, GA 30083

5234 Memorial Dr
Ste 1101
Stone Mountain, GA 30083

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X Yes
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208D00000X
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Other providers in Miami, FL

All providers in Miami, FL · Internal Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.