Provider Demographics
NPI:1295964393
Name:HCS PRIMARY CARE ASSOCIATES
Entity type:Organization
Organization Name:HCS PRIMARY CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DHATRIKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-215-6369
Mailing Address - Street 1:483 N SEMORAN BLVD
Mailing Address - Street 2:SUITE# 104A
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3800
Mailing Address - Country:US
Mailing Address - Phone:407-215-6369
Mailing Address - Fax:407-937-2505
Practice Address - Street 1:483 N SEMORAN BLVD
Practice Address - Street 2:SUITE# 104A
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3800
Practice Address - Country:US
Practice Address - Phone:407-215-6369
Practice Address - Fax:407-937-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care