Provider Demographics
NPI:1811365646
Name:PREMIER NEUROLOGY AND WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:PREMIER NEUROLOGY AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:YONO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-210-2447
Mailing Address - Street 1:1050 SE MONTEREY RD STE 201
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4512
Mailing Address - Country:US
Mailing Address - Phone:772-210-2447
Mailing Address - Fax:772-261-4028
Practice Address - Street 1:1050 SE MONTEREY RD STE 201
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4512
Practice Address - Country:US
Practice Address - Phone:772-210-2447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty