Provider Demographics
NPI:1194538157
Name:HOSANNA PRIMARY CARE INC
Entity type:Organization
Organization Name:HOSANNA PRIMARY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUSTANE
Authorized Official - Middle Name:
Authorized Official - Last Name:PETIT-ALLONCE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:954-507-0026
Mailing Address - Street 1:2021 NW 69TH TER
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-2019
Mailing Address - Country:US
Mailing Address - Phone:954-507-0026
Mailing Address - Fax:954-301-7634
Practice Address - Street 1:4699 N FEDERAL HWY STE 104
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6510
Practice Address - Country:US
Practice Address - Phone:954-507-0026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty