| Premier Medical Associates Llc | |
|
2109 59th St W Bradenton FL 34209-7015 | |
| (941) 761-3777 | |
| (941) 761-3779 |
| Full Name | Premier Medical Associates Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2109 59th St W, Bradenton, Florida |
| Authorized Official Name and Position | Gustavo B Arrojo (OWNER) |
| Authorized Official Contact | 9417613777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Medical Associates Llc Po Box 14056 Bradenton FL 34280-4056 Ph: (941) 761-3777 | Premier Medical Associates Llc 2109 59th St W Bradenton FL 34209-7015 Ph: (941) 761-3777 |
| NPI Number | 1871609040 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 03/29/2012 |
| Medicare PECOS PAC ID | 4486615242 |
|---|---|
| Medicare Enrollment ID | O20041025000594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871609040 | NPI | - | NPPES |
| 251289100 | Medicaid | FL | |
| P00173098 | Other | FL | RAILROAD MEDICARE PTAN |
| DC5035 | Other | FL | RR MEDICARE PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0071298 (Florida) | Primary |
| Provider Name | Gustavo B Arrojo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992798151 PECOS PAC ID: 4183608060 Enrollment ID: I20041103000302 |
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