Provider Demographics
NPI:1588445514
Name:ACE PRIMARY CARE LLC
Entity type:Organization
Organization Name:ACE PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISTAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:CO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-462-4334
Mailing Address - Street 1:1407 E ALLEGRIE DR
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34453-3658
Mailing Address - Country:US
Mailing Address - Phone:810-406-7175
Mailing Address - Fax:
Practice Address - Street 1:700 SE 5TH TER STE 2
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-4865
Practice Address - Country:US
Practice Address - Phone:352-462-4334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty