| Premier Internal Medicine | |
|
11321 Countryway Blvd Tampa FL 33626-2610 | |
| (813) 814-4204 | |
| (813) 814-4219 |
| Full Name | Premier Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 11321 Countryway Blvd, Tampa, Florida |
| Authorized Official Name and Position | Alex Zelenka (PRESIDENT) |
| Authorized Official Contact | 7276416840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Internal Medicine 11321 Countryway Blvd Tampa FL 33626-2610 Ph: (813) 814-4204 | Premier Internal Medicine 11321 Countryway Blvd Tampa FL 33626-2610 Ph: (813) 814-4204 |
| NPI Number | 1932378882 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 10/20/2008 |
| Medicare PECOS PAC ID | 3375607468 |
|---|---|
| Medicare Enrollment ID | O20090204000657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932378882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME88286 (Florida) | Primary |
| Provider Name | Alexandra P Zelenka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023297199 PECOS PAC ID: 5294899381 Enrollment ID: I20090204000651 |
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