Provider Demographics
NPI:1871370973
Name:PRINCIPLE CARE CENTER INC
Entity type:Organization
Organization Name:PRINCIPLE CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRTA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLASENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-350-3223
Mailing Address - Street 1:4445 W 16TH AVE STE 602
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2960
Mailing Address - Country:US
Mailing Address - Phone:786-334-5663
Mailing Address - Fax:
Practice Address - Street 1:12 S ORLANDO AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5674
Practice Address - Country:US
Practice Address - Phone:407-350-3223
Practice Address - Fax:321-512-5269
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRINCIPLE CARE CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health