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1184384349
BEACON PRIMARY CARE LLC
LUTZ, FL
NPI
1184384349
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Entity Type
Organization
Authorized Contact
TYLER PENROD
Biller
832-289-9225
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2021-12-29
Last Update Date
2021-12-29
Business Address
BEACON PRIMARY CARE LLC
17819 TIDEWATER BAY LN
LUTZ, FL 33549-5419
Phone number: 813-447-9249
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Mailing Address
BEACON PRIMARY CARE LLC
17819 TIDEWATER BAY LN
LUTZ, FL 33549-5419
Phone number: 813-447-9249
Copy
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