| Premium Healthcare Holdings, Lllp | |
|
14505 Commerce Way Miami Lakes FL 33016-1597 | |
| (305) 265-4441 | |
| (305) 265-4844 |
| Full Name | Premium Healthcare Holdings, Lllp |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 14505 Commerce Way, Miami Lakes, Florida |
| Authorized Official Name and Position | Keila Hoover (OWNER) |
| Authorized Official Contact | 3052654441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premium Healthcare Holdings, Lllp 2400 Sw 69th Ave Miami FL 33155-2919 Ph: (205) 265-4441 | Premium Healthcare Holdings, Lllp 14505 Commerce Way Miami Lakes FL 33016-1597 Ph: (305) 265-4441 |
| NPI Number | 1447968581 |
|---|---|
| Provider Enumeration Date | 11/08/2022 |
| Last Update Date | 11/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447968581 | NPI | - | NPPES |
| 115232600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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