Provider Demographics
NPI:1336275940
Name:PREMIER ORTHOPEDICS, INC.
Entity Type:Organization
Organization Name:PREMIER ORTHOPEDICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE ASSOCIATE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-814-4122
Mailing Address - Street 1:16307 PAYTON CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2766
Mailing Address - Country:US
Mailing Address - Phone:813-814-4122
Mailing Address - Fax:813-814-4144
Practice Address - Street 1:16307 PAYTON CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2766
Practice Address - Country:US
Practice Address - Phone:813-814-4122
Practice Address - Fax:813-814-4144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL131950.0000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies