Provider Demographics
NPI:1437599438
Name:A&B PREMIER MEDICAL SERVICES
Entity Type:Organization
Organization Name:A&B PREMIER MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABU AOUF
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:239-244-1091
Mailing Address - Street 1:10390 WASHINGTONIA PALM WAY APT 4424
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-7992
Mailing Address - Country:US
Mailing Address - Phone:239-244-1091
Mailing Address - Fax:
Practice Address - Street 1:10390 WASHINGTONIA PALM WAY APT 4424
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-7992
Practice Address - Country:US
Practice Address - Phone:239-244-1091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105138363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty