| Centerwell Senior Primary Care (la) Pc | |
| 
					17123 Commerce Centre Dr Prairieville LA 70769-3481  | |
| (407) 447-7120 | |
| Not Available | 
| Full Name | Centerwell Senior Primary Care (la) Pc | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 17123 Commerce Centre Dr, Prairieville, Louisiana | 
| Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) | 
| Authorized Official Contact | 4074477120 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Centerwell Senior Primary Care (la) Pc 6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000  | Centerwell Senior Primary Care (la) Pc 17123 Commerce Centre Dr Prairieville LA 70769-3481 Ph: (407) 447-7120  | 
| NPI Number | 1518737766 | 
|---|---|
| Provider Enumeration Date | 01/08/2024 | 
| Last Update Date | 08/22/2024 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1518737766 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary | 
| 208D00000X | General Practice | (* (Not Available)) | Secondary | 
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary | 
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