Lifetime Medical Care PA
Clinic/Center, Primary Care in Orange Park, FL. Organization (NPI-2).
NPI number1790793016
StatusActive
Last updated in NPPESNov 6, 2008
Details
- NPI
- 1790793016
- Entity type
- Organization (NPI-2)
- Legal business name
- Lifetime Medical Care PA
- Organization subpart
- No
- Enumeration date
- Aug 3, 2006
- Last updated
- Nov 6, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | ME81222 | FL | Yes |
Practice location
2300 Park AveSuite 203
Orange Park, FL 32073-5571
Phone 904-278-0016 · Fax 904-278-4217
Mailing address
5000 Us Highway 17Suite 18-302
Orange Park, FL 32003-8231
Phone 904-278-0016 · Fax 904-278-4217
Authorized official
Nidal El Rimawi
President
9042780016
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