Provider Demographics
NPI: | 1750558813 |
---|---|
Name: | PREMIER CARE SOLUTIONS LLC |
Entity type: | Organization |
Organization Name: | PREMIER CARE SOLUTIONS LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARIO |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TORRES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 305-559-6369 |
Mailing Address - Street 1: | 3850 SW 87TH AVE |
Mailing Address - Street 2: | #306 |
Mailing Address - City: | MIAMI |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33165-5400 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 305-559-6369 |
Mailing Address - Fax: | 305-559-6371 |
Practice Address - Street 1: | 3850 SW 87TH AVE |
Practice Address - Street 2: | #306 |
Practice Address - City: | MIAMI |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33165-5400 |
Practice Address - Country: | US |
Practice Address - Phone: | 305-559-6369 |
Practice Address - Fax: | 305-559-6371 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-05-08 |
Last Update Date: | 2008-05-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | 208D00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty |