Awa Primary Care PLLC

Organization Active NPI Primary Care Clinic/Center · Indialantic, FL

NPI 1699523340 · NPPES record last updated May 8, 2024

Key facts

NPI
1699523340
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
Legal business name
AWA PRIMARY CARE PLLC
Practice address
97 Niemira Ave Apt E
Indialantic, FL 32903-2936
Phone
(407) 579-1616
Fax
(855) 642-2122
NPI assigned
May 8, 2024
Organization subpart
No

Authorized official

Name
Arilma Milagros Wong Arjona, NP
Title
Ceo
Phone
(407) 579-1616

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20260326002468 FL Part B Supplier - Clinic/Group Practice 5193200277 Receives reassigned benefits from 1 practitioner
Practice locations: Indialantic, FL

National Provider Directory

Locations

200 N Palm Ave
Unit 33451
Indialantic, FL 32903

150 Coconut Dr
Ste 101C
Indialantic, FL 32903

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Yes

Addresses

Primary practice location

97 Niemira Ave Apt E
Indialantic, FL 32903-2936

Mailing address

200 N Palm Ave Unit 33451
Indialantic, FL 32903-5019
Phone (407) 579-1616

Other providers in Indialantic, FL

All providers in Indialantic, FL · Primary Care Clinic/Center in Florida

Sources for this page

Verify at the official NPI Registry.