Advance Primary Care LLC
Organization Active NPI General Practice Physician · Ocala, FL
NPI 1669909305 · NPPES record last updated May 12, 2017
Key facts
- NPI
- 1669909305
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- License
- ACN-194 (FL)
- Legal business name
- ADVANCE PRIMARY CARE LLC
- Practice address
- 1133 SE 18TH PL
Suite 2
Ocala, FL 34471 - Phone
- (352) 861-5765
- Fax
- (352) 867-1801
- NPI assigned
- May 12, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Jaime Eli Rubio, MD
- Title
- Owner
- Phone
- (352) 286-9255
Subparts reporting this organization as parent 1
Practitioners 2
-
Sandy Caterine Gomez, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171110002635 | FL | Part B Supplier - Clinic/Group Practice | 1658637467 |
Receives reassigned benefits from 2 practitioners Practice locations: Ocala, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | ACN-194 | FL | Yes |
Addresses
Primary practice location
1133 SE 18TH PL
Suite 2
Ocala, FL 34471
Mailing address
1133 SE 18TH PL
Suite 2
Ocala, FL 34471-5410
Phone (352) 861-5765
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 280272400 | Medicaid | FL |
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All providers in Ocala, FL · General Practice Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.