Organization Active NPI

Lakewood Ranch Primary Care Associates

  • Family Medicine Physician
  • Bradenton, FL
National Provider Identifier
1699219113
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME83175 Issued in FL
Legal business name
LAKEWOOD RANCH PRIMARY CARE ASSOCIATES
Practice address
822 62ND Street Cir E
Suite 102
Bradenton, FL 34208-6208
Phone
(941) 243-3983
Fax
(941) 896-3795
NPI assigned
Dec 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Authorized official

Name
Paul M Pulcini, M.D.
Title
Doctor
Phone
(813) 269-6426

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME83175 FL Primary

Addresses

Primary practice location

822 62ND Street Cir E
Suite 102
Bradenton, FL 34208-6208

Mailing address

6101 Webb Rd
Suite 203
Tampa, FL 33615-2872
Phone (813) 269-6426

National Provider Directory

National Provider Directory

Locations

6101 Webb Rd
Ste 203
Tampa, FL 33615
Phone (813) 884-4794

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1699219113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 WEBB RD",
            "address_2": "SUITE 203",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336152872",
            "telephone_number": "813-269-6426",
            "fax_number": "813-342-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 62ND STREET CIR E",
            "address_2": "SUITE 102",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342086208",
            "telephone_number": "941-243-3983",
            "fax_number": "941-896-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD RANCH PRIMARY CARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "PULCINI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "813-269-6426",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME83175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.