Premier Physician Associates, P.a. | |
110 Pond Ct Ste 301 Debary FL 32713-2717 | |
(818) 575-0204 | |
Not Available |
Full Name | Premier Physician Associates, P.a. |
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Speciality | Family Medicine |
Location | 110 Pond Ct Ste 301, Debary, Florida |
Authorized Official Name and Position | Irelis Rodriguez Castro (OWNER) |
Authorized Official Contact | 8185750204 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Premier Physician Associates, P.a. 110 Pond Ct Ste 301 Debary FL 32713-2717 Ph: () - | Premier Physician Associates, P.a. 110 Pond Ct Ste 301 Debary FL 32713-2717 Ph: (818) 575-0204 |
NPI Number | 1073396073 |
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Provider Enumeration Date | 08/15/2023 |
Last Update Date | 08/15/2023 |
Medicare PECOS PAC ID | 2466816319 |
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Medicare Enrollment ID | O20230912001560 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073396073 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Irelis Rodriguez Castro |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1356714661 PECOS PAC ID: 7810292752 Enrollment ID: I20170221000253 |
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