PRIMECARE AT TWIN LAKES LLC (NPI# 1902809122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902809122 |
| Entity Type | Organization |
| Organization Name | PRIMECARE AT TWIN LAKES LLC |
| Practice Address |
1890 Lpga Blvd Ste 130 Daytona Beach FL 32117-7130 |
| Mailing Address |
1890 Lpga Blvd Suite 130 Daytona Beach FL 32117-7130 |
| Practice Telephone | 3862742212 |
| Practice Fax Number | 3862741508 |
| Mailing Telephone | 3862742212 |
| Mailing Fax Number | 3862741508 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2011-05-06 |
| Authorized Official Name | CHARLES DUVA (PRESIDENT) |
| Authorized Official Telephone | 3862747800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
ME47294 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BC/BS OF FL PA GROUP | 77984 | 01 |
| FL | RAILROAD MEDICARE GROUP | DC0901 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104072594 | Primecare At Twin Lakes LLC | Clinic/Center | 1327 Saxon Dr, New Smyrna Beach, FL 32169-3160 | 2008-08-18 |
| 1154601706 | Primecare At Twin Lakes LLC | Clinic/Center | 1890 Lpga Blvd, Suite 130, Daytona Beach, FL 32117-7130 | 2011-08-26 |
| 1578745428 | Primecare At Twin Lakes LLC | Emergency Medicine | 21 Hospital Dr, Suite 120, Palm Coast, FL 32164 | 2007-12-03 |
| Street Address |
1890 LPGA BLVD STE 130 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-7130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649601485 | Primecare Acquisition Inc | Non-Pharmacy Dispensing Site | 1890 Lpga Blvd, Suite 130, Daytona Beach, FL 32117-7130 | 2013-12-04 |
| 1093069395 | James T Sutton Md Pa | Surgery | 1890 Lpga Blvd, Ste 250, Daytona Beach, FL 32117-7130 | 2012-11-08 |
| 1659622686 | Michael P. Harrington, M.d., P.a. | Surgery | 1890 Lpga Blvd, Ste 250, Daytona Beach, FL 32117-7130 | 2012-10-01 |
| 1598015398 | Dale R Traficante Md Pa | Urology | 1890 Lpga Blvd, Suite 220, Daytona Beach, FL 32117-7138 | 2012-09-19 |
| 1962777185 | David G Ramshaw Md Pa | Specialist | 1890 Lpga Blvd, Ste 250, Daytona Beach, FL 32117-7130 | 2012-03-21 |
| 1114201647 | Surgical Associates of Volusia | Specialist | 1890 Lpga Blvd, Suite 250, Daytona Beach, FL 32117-7130 | 2011-10-03 |
| 1154601706 | Primecare At Twin Lakes LLC | Clinic/Center | 1890 Lpga Blvd, Suite 130, Daytona Beach, FL 32117-7130 | 2011-08-26 |
| 1225328289 | Florida Woman Care, LLC | Obstetrics & Gynecology | 1890 Lpga Blvd, Suite 160, Daytona Beach, FL 32117-7130 | 2011-04-12 |
| 1255644969 | Florida Endovascular Specialists LLC | Radiology | 1890 Lpga Blvd, Suite 140, Daytona Beach, FL 32117-7130 | 2010-07-22 |
| 1184854465 | Primecare Family Medicine LLC | Family Medicine | 1890 Lpga Blvd, Suite 130, Daytona Beach, FL 32117-7130 | 2009-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043604226 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1014 W International Speedway Blvd, Daytona Beach, FL 32114 | 2015-03-25 |
| 1083887657 | Prompt Care, Pl | Clinic/Center | 2562 S Atlantic Ave, Daytona Beach, FL 32118-5523 | 2008-04-03 |
| 1154601706 | Primecare At Twin Lakes LLC | Clinic/Center | 1890 Lpga Blvd, Suite 130, Daytona Beach, FL 32117-7130 | 2011-08-26 |
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| 1689273187 | American Urgent Care and Walk In Clinics LLC | Clinic/Center | 601 Gray Ave, Wildwood, FL 34785-3520 | 2020-10-26 |
| 1619575529 | Medec Urgent Care Pllc | Clinic/Center | 600 Garden St, Titusville, FL 32796-3489 | 2020-10-13 |
| 1144835182 | Adventist Health System/sunbelt, Inc | Clinic/Center | 11826 State Road 54, Odessa, FL 33556-3496 | 2020-09-15 |
| 1528671096 | Crucialist LLC | Clinic/Center | 4230 Pablo Professional Ct Ste 103, Jacksonville, FL 32224-3223 | 2020-08-25 |
| 1194334961 | Md Now Medical Centers Inc | Clinic/Center | 4332 Cortez Rd W, Bradenton, FL 34210-3139 | 2020-07-28 |
| 1558970327 | Md Now Medical Centers Inc | Clinic/Center | 15165 Mcgregor Blvd, Fort Myers, FL 33908-1957 | 2020-07-28 |
| 1386253151 | Md Now Medical Centers Inc | Clinic/Center | 12748 S Cleveland Ave, Fort Myers, FL 33907-3823 | 2020-07-28 |
| 1821607698 | Md Now Medical Centers Inc | Clinic/Center | 2609 Santa Barbara Blvd, Cape Coral, FL 33914-4457 | 2020-07-28 |
| 1366051435 | Md Now Medical Centers Inc | Clinic/Center | 9690 Glades Rd Unit 425, Boca Raton, FL 33434-3978 | 2020-07-24 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
Please comment or provide details below to improve the information on PRIMECARE AT TWIN LAKES LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.