Provider Demographics
NPI:1992431233
Name:MYPRIMARY, LLC
Entity type:Organization
Organization Name:MYPRIMARY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATISTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-397-5188
Mailing Address - Street 1:495 MARINER BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5680
Mailing Address - Country:US
Mailing Address - Phone:352-397-5188
Mailing Address - Fax:352-293-4046
Practice Address - Street 1:495 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5680
Practice Address - Country:US
Practice Address - Phone:352-397-5188
Practice Address - Fax:352-293-4046
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MYPRIMARY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care