Myrtle Ridge Primary Care, P.a is a Counselor Clinic in Lutz, Florida. It is located at 1539 Dale Mabry Hwy Ste 102, Lutz, FL and its contact number is 813-909-7102. The authorized person for Myrtle Ridge Primary Care, P.a is Yudaisy Mogena Padron
who is Owner of the clinic and his/her contact number is 813-909-7102.
Myrtle Ridge Primary Care, P.a Clinic has counselors who are trained and educated in the performance of behavior health services through interpersonal communications and analysis. Counselors offer guidance to individuals, couples, families and groups who are dealing with issues that affect their mental health and well-being.
Complete Clinic Profile:
Myrtle Ridge Primary Care, P.a Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Myrtle Ridge Primary Care, P.a |
| Specialization: | Mental Health Counselor |
| Clinic Address: | 1539 Dale Mabry Hwy Ste 102, Lutz,
Florida, 33548-3008 |
| Phone: | 813-909-7102 |
| Fax: | 813-909-0199 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Yudaisy Mogena Padron |
| Position: | Owner |
| Contact Number: | 813-909-7102 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Myrtle Ridge Primary Care, P.a clinic are as mentioned below.
| NPI Number: | 1619504354 |
| NPI Enumeration Date: | 24 Mar, 2020 |
| NPI Last Update On: | 08 Jan, 2026 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Myrtle Ridge Primary Care, P.a are as mentioned below.
| Specialization | License Number | State | Status | |
| General Practice | | | Primary | |
| Mental Health | | | Secondary | |
| Psychologist | | | Secondary | |
| Physician Assistant | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 10D1050075 | Other | Florida | Clia |
| 129484600 | Medicaid | Florida | |
| 129485400 | Medicaid | Florida | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Myrtle Ridge Primary Care, P.a
1539 Dale Mabry Hwy Ste 102,
Lutz, Florida |
| Zip: | 33548-3008 |
| Phone Number: | -- |
| Fax Number: | -- |
Patients can reach Myrtle Ridge Primary Care, P.a at
1539 Dale Mabry Hwy Ste 102, Lutz, Florida or can
call to book an appointment on 813-909-7102.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 February, 2026.