Provider Demographics
NPI:1124551429
Name:PRIME HEALTH PARTNERS LLC
Entity type:Organization
Organization Name:PRIME HEALTH PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ZEFF
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:BONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-787-1260
Mailing Address - Street 1:1694 BAYHILL DR
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-1956
Mailing Address - Country:US
Mailing Address - Phone:727-439-2677
Mailing Address - Fax:727-431-6870
Practice Address - Street 1:14100 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 132
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-7241
Practice Address - Country:US
Practice Address - Phone:727-439-2677
Practice Address - Fax:727-431-6870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363L00000X
FLOS6109208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty