Internal Medicine
CENTERWELL SENIOR PRIMARY CARE (LA) PC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1497525661 · enumerated 2024-01-08 · record updated 2024-08-22. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: ANGIE MARTINEZ, Senior Credentialing Professional · (407) 447-7120
Other names: CENTERWELL SENIOR PRIMARY CARE- SOUTH SHREVEPORT
Addresses and phones
- Mailing address 6101 BLUE LAGOON DR STE 200, MIAMI, FL, 33126-3168 (305) 500-2000 Google Maps Apple Maps OpenStreetMap
- Practice location 2020 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA, 71118-3315 (407) 447-7120 Google Maps Apple Maps OpenStreetMap
Specialties
- Family Medicine 207Q00000X
- Internal Medicine 207R00000X · Primary
- General Practice 208D00000X
In this directory
Locations and evidence
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Practice location
SHREVEPORT, LA, 711183315
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.