| Awa Primary Care PLLC | |
|
97 Niemira Ave Apt E Indialantic FL 32903-2936 | |
| (407) 579-1616 | |
| (855) 642-2122 |
| Full Name | Awa Primary Care PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 97 Niemira Ave Apt E, Indialantic, Florida |
| Authorized Official Name and Position | Arilma Milagros Wong Arjona (CEO) |
| Authorized Official Contact | 4075791616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Awa Primary Care PLLC 200 N Palm Ave Unit 33451 Indialantic FL 32903-5019 Ph: (407) 579-1616 | Awa Primary Care PLLC 97 Niemira Ave Apt E Indialantic FL 32903-2936 Ph: (407) 579-1616 |
| NPI Number | 1699523340 |
|---|---|
| Provider Enumeration Date | 05/08/2024 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Medicare PECOS PAC ID | 5193200277 |
|---|---|
| Medicare Enrollment ID | O20260326002468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699523340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Arilma Milagros Wong-arjona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598236697 PECOS PAC ID: 4284034372 Enrollment ID: I20210610002498 |
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