| East Florida Premium Medical Care | |
|
7421 N. University Drive Ste 314 Tamarac FL 33321 | |
| (954) 724-3440 | |
| (954) 724-3494 |
| Full Name | East Florida Premium Medical Care |
|---|---|
| Speciality | General Practice |
| Location | 7421 N. University Drive, Tamarac, Florida |
| Authorized Official Name and Position | Errol Earl Campbell (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9547243440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Florida Premium Medical Care 7421 N. University Drive Ste 314 Tamarac FL 33321 Ph: (954) 724-3440 | East Florida Premium Medical Care 7421 N. University Drive Ste 314 Tamarac FL 33321 Ph: (954) 724-3440 |
| NPI Number | 1326312125 |
|---|---|
| Provider Enumeration Date | 02/27/2012 |
| Last Update Date | 11/18/2022 |
| Medicare PECOS PAC ID | 2365607702 |
|---|---|
| Medicare Enrollment ID | O20120710000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326312125 | NPI | - | NPPES |
| 109864400 | Medicaid | FL | |
| 000758100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME80593 (Florida) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Errol E Campbell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427036995 PECOS PAC ID: 5597757302 Enrollment ID: I20040401000438 |
| Provider Name | Sergio Fernandez Acosta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174159719 PECOS PAC ID: 7416348099 Enrollment ID: I20211216000582 |
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