Provider Demographics
NPI:1447929468
Name:PGIC HEALTHCARE INC
Entity type:Organization
Organization Name:PGIC HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER - FAMILY
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GONZALEZ PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:786-567-2561
Mailing Address - Street 1:1860 TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6586
Mailing Address - Country:US
Mailing Address - Phone:786-567-2561
Mailing Address - Fax:
Practice Address - Street 1:1495 FOREST HILL BLVD STE A3
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6073
Practice Address - Country:US
Practice Address - Phone:561-270-0267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care