Organization Name: | PREMIER PEDIATRICS LLC |
NPI Number: | 1104205632 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FARID EUNUS (COO) |
Mailing Address: | 14141 E Highway 40 Unit B Silver Springs |
State: | FL US |
Postal Code: | 344883933 |
Phone Number: | 3525120466 |
Fax Number: | 3525120374 |
NPI Enumeration Date: | 05/29/2015 |
NPI Last Update Date: | 05/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |