| Premiere Care Providers Llc | |
|
8550 Ne 138th Ln Bldg 800 Lady Lake FL 32159-6816 | |
| (352) 391-5299 | |
| (877) 786-6531 |
| Full Name | Premiere Care Providers Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8550 Ne 138th Ln Bldg 800, Lady Lake, Florida |
| Authorized Official Name and Position | Deborah Townsend (OFFICE MANAGER) |
| Authorized Official Contact | 3523915299 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premiere Care Providers Llc 8550 Ne 138th Ln Bldg 800 Lady Lake FL 32159-6816 Ph: (352) 391-5299 | Premiere Care Providers Llc 8550 Ne 138th Ln Bldg 800 Lady Lake FL 32159-6816 Ph: (352) 391-5299 |
| NPI Number | 1225675895 |
|---|---|
| Provider Enumeration Date | 12/03/2019 |
| Last Update Date | 12/03/2019 |
| Medicare PECOS PAC ID | 7810388535 |
|---|---|
| Medicare Enrollment ID | O20220106000878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225675895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Arturo R Castro |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1427052901 PECOS PAC ID: 3476526930 Enrollment ID: I20040823001350 |
| Provider Name | Abu N Azizullah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538130117 PECOS PAC ID: 8921073396 Enrollment ID: I20040902001220 |
| Provider Name | Himanshu Pathak |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700054939 PECOS PAC ID: 6901093905 Enrollment ID: I20210810004201 |
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