| Premise Health Of Florida Medical, P.a. | |
|
1680 Se Lyngate Dr Ste 101 Port St Lucie FL 34952-4300 | |
| (352) 483-9199 | |
| (352) 240-3907 |
| Full Name | Premise Health Of Florida Medical, P.a. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1680 Se Lyngate Dr Ste 101, Port St Lucie, Florida |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Florida Medical, P.a. 5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | Premise Health Of Florida Medical, P.a. 1680 Se Lyngate Dr Ste 101 Port St Lucie FL 34952-4300 Ph: (352) 483-9199 |
| NPI Number | 1518631654 |
|---|---|
| Provider Enumeration Date | 08/03/2021 |
| Last Update Date | 08/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518631654 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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