| Premier Clinic Llc | |
|
7807 Baymeadows Rd E Suite 209 Jacksonville FL 32256-9666 | |
| (904) 565-9270 | |
| (904) 567-3058 |
| Full Name | Premier Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7807 Baymeadows Rd E, Jacksonville, Florida |
| Authorized Official Name and Position | Dinesh D. Patel (PRESIDENT) |
| Authorized Official Contact | 9045659270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Clinic Llc 7807 Baymeadows Rd E Suite 209 Jacksonville FL 32256-9666 Ph: (904) 565-9270 | Premier Clinic Llc 7807 Baymeadows Rd E Suite 209 Jacksonville FL 32256-9666 Ph: (904) 565-9270 |
| NPI Number | 1316134323 |
|---|---|
| Provider Enumeration Date | 10/03/2007 |
| Last Update Date | 02/16/2011 |
| Medicare PECOS PAC ID | 9739276205 |
|---|---|
| Medicare Enrollment ID | O20071030000606 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316134323 | NPI | - | NPPES |
| 373614800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | ME55622 (Florida) | Primary |
| Provider Name | Dinesh D Patel |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1225094527 PECOS PAC ID: 2668560954 Enrollment ID: I20071120000595 |
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