Provider Demographics
NPI:1225356009
Name:SERVICES IN PRIMARY CARE, PA
Entity type:Organization
Organization Name:SERVICES IN PRIMARY CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DULCE
Authorized Official - Middle Name:ZUNILDA
Authorized Official - Last Name:TAVERAS UCETA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-919-4355
Mailing Address - Street 1:PO BOX 10876
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-0876
Mailing Address - Country:US
Mailing Address - Phone:239-919-4355
Mailing Address - Fax:
Practice Address - Street 1:7130 BLUE JUNIPER CT
Practice Address - Street 2:UNIT 101
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-7870
Practice Address - Country:US
Practice Address - Phone:239-919-4355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98472207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty