Primecare Family Medical Centers Osceola LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME78770 Issued in FL

Legal business name

PRIMECARE FAMILY MEDICAL CENTERS OSCEOLA LLC

Practice address

217 E Oak St
Kissimmee, FL 34744-4503

Phone

(407) 988-1035

Fax

(407) 988-1034

NPI assigned

Jan 9, 2018

Organization subpart

No

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

Authorized official

Name

Rene Casanova, MD

Title

Owner/President

Phone

(305) 442-1740

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1841707171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7765 NW 48TH ST STE 300",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331665404",
            "telephone_number": "305-442-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444503",
            "telephone_number": "407-988-1035",
            "fax_number": "407-988-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE FAMILY MEDICAL CENTERS OSCEOLA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "CASANOVA",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "305-442-1740",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME78770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264910101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gabrielle Prince
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• General Practice Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; 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.