Myrtle Ridge Primary Care, PA
Myrtle Ridge Primary Care, PA is a Case Management Agency in Lutz, Florida. Registered with an NPI since 2021.
- In the registry since
- 2021
- Specialties on file
- 2
What do these letters mean?
- PA — Professional association
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1539 Dale Mabry Hwy Ste 102Lutz, FL 33548-3008
Phone: (813) 909-7102
Fax: (813) 909-0199
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Case Management Agency (primary) | Taxonomy 251B00000X |
|---|---|
| Community Health Clinic/Center | Taxonomy 261QC1500X |
Record details
| NPI number | 1700553633 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Yudaisy Mogena — Office Manager · (813) 909-7102 |
| NPI enumerated | August 27, 2021 |
| Last updated in NPPES | May 6, 2024 |
| Certification date | May 6, 2024 |
| Mailing address | 1539 Dale Mabry Hwy Ste 102, Lutz, FL 33548-3008 |
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Mrs. Kristin Kelly White, BA
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