Provider Demographics
NPI:1598970030
Name:PREMIER HEALTH SOLUTIONJS
Entity Type:Organization
Organization Name:PREMIER HEALTH SOLUTIONJS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASTELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-871-8451
Mailing Address - Street 1:6555 NW 36TH ST
Mailing Address - Street 2:SUITE 309
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6978
Mailing Address - Country:US
Mailing Address - Phone:305-871-8451
Mailing Address - Fax:
Practice Address - Street 1:6555 NW 36TH ST
Practice Address - Street 2:SUITE 309
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166-6978
Practice Address - Country:US
Practice Address - Phone:305-871-8451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7539261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center