Provider Demographics
NPI:1306584677
Name:AT HOME PRIMARY CARE, LLC
Entity type:Organization
Organization Name:AT HOME PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIEULUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HONORAT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-386-9386
Mailing Address - Street 1:572 E MCNAB RD STE 103
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-9355
Mailing Address - Country:US
Mailing Address - Phone:954-386-9386
Mailing Address - Fax:786-619-3502
Practice Address - Street 1:572 E MCNAB RD STE 103
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-9355
Practice Address - Country:US
Practice Address - Phone:954-386-9386
Practice Address - Fax:786-619-3502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty