Island Direct Primary Care Llc

LBN: Island Direct Primary Care Llc
Island Direct Primary Care Llc is an health care organization with primary practice located at 390 N Courtenay Pkwy , Merritt Island FL 32953-3456. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Island Direct Primary Care Llc can be contacted via phone (321) 506-2540, or through Rothwell, John Wesley via phone (321) 506-2540.

Contact Information

Primary practice address
390 N Courtenay Pkwy Merritt Island FL 32953-3456
Phone: (321) 506-2540
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Rothwell, John Wesley DNP
Phone: (321) 506-2540

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1811463961
LBN Legal business name Island Direct Primary Care Llc
DBA Doing business as
Authorized official Rothwell, John Wesley DNP
Entity Organization
Organization subpart 1 No
Enumeration date Oct 16th, 2018
Last updated Mar 27th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811463961 NPPES
Florida MEDICAID 1679943740

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