| Organization Name: | PRIMECARE SUN CITY, LLC |
| NPI Number: | 1255628624 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAMELA M RUESCH (ADMINISTRATOR) |
| Mailing Address: | 139 S Pebble Beach Blvd Suite 207 Sun City Center |
| State: | FL US |
| Postal Code: | 335735799 |
| Phone Number: | 8134155038 |
| Fax Number: | |
| NPI Enumeration Date: | 07/06/2011 |
| NPI Last Update Date: | 12/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |