| Suncoast Premier Medical Llc | |
|
40107 Highway 27 Fl 2 Davenport FL 33837-5901 | |
| (352) 243-3555 | |
| (352) 243-6614 |
| Full Name | Suncoast Premier Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 40107 Highway 27 Fl 2, Davenport, Florida |
| Authorized Official Name and Position | Mario Rene Perez (OWNER) |
| Authorized Official Contact | 8632076554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suncoast Premier Medical Llc Po Box 470459 Celebration FL 34747 Ph: (352) 243-3555 | Suncoast Premier Medical Llc 40107 Highway 27 Fl 2 Davenport FL 33837-5901 Ph: (352) 243-3555 |
| NPI Number | 1427206739 |
|---|---|
| Provider Enumeration Date | 08/29/2008 |
| Last Update Date | 11/14/2024 |
| Medicare PECOS PAC ID | 8426114208 |
|---|---|
| Medicare Enrollment ID | O20090303000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427206739 | NPI | - | NPPES |
| 277533600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME72969 (Florida) | Primary |
| Provider Name | Mario R Perez Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528052420 PECOS PAC ID: 7911804471 Enrollment ID: I20031215000323 |
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