NPIMap

Organization Active NPI

Wildwood Primary Care Associates

  • Family Medicine Physician
  • Wildwood, FL
National Provider Identifier
1801497953
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WILDWOOD PRIMARY CARE ASSOCIATES
Practice address
5814 Seven Mile Dr Ste 105
Wildwood, FL 34785-8869
Phone
(813) 269-6426
NPI assigned
Nov 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Authorized official

Name
Jeanine Perez
Title
Admin
Phone
(813) 269-6426

Specialties & licenses 1

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

Addresses

Primary practice location

5814 Seven Mile Dr Ste 105
Wildwood, FL 34785-8869

Mailing address

5814 Seven Mile Dr Ste 105
Wildwood, FL 34785-8869
Phone (813) 269-6426

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1801497953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5814 SEVEN MILE DR STE 105",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347858869",
            "telephone_number": "813-269-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5814 SEVEN MILE DR STE 105",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347858869",
            "telephone_number": "813-269-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD PRIMARY CARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "813-269-6426"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.