| Premier Pediatrics - Anthony | |
|
2040 Ne 95th St Anthony FL 32617-3628 | |
| (352) 509-5082 | |
| (352) 509-5083 |
| Full Name | Premier Pediatrics - Anthony |
|---|---|
| Speciality | Clinic/Center |
| Location | 2040 Ne 95th St, Anthony, Florida |
| Authorized Official Name and Position | Shahab Eunus (OWNER) |
| Authorized Official Contact | 3525095082 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Pediatrics - Anthony 7960 Sw 60th Ave Ste 100 Ocala FL 34476-6409 Ph: (352) 671-6741 | Premier Pediatrics - Anthony 2040 Ne 95th St Anthony FL 32617-3628 Ph: (352) 509-5082 |
| NPI Number | 1942006853 |
|---|---|
| Provider Enumeration Date | 02/21/2025 |
| Last Update Date | 02/21/2025 |
| Certification Date | 02/21/2025 |
| Medicare PECOS PAC ID | 5294869236 |
|---|---|
| Medicare Enrollment ID | O20250519001644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942006853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 208000000X | Pediatrics | () | Secondary |
| 208D00000X | General Practice | () | Secondary |
| 261QR1300X | Clinic/center - Rural Health | () | Primary |