| Premier Pediatrics LLC | |
|
5388 S Us Highway 41 Dunnellon FL 34432-2042 | |
| (352) 671-6741 | |
| (352) 671-6742 |
| Full Name | Premier Pediatrics LLC |
|---|---|
| Speciality | Pediatrics |
| Location | 5388 S Us Highway 41, Dunnellon, Florida |
| Authorized Official Name and Position | Shahab Eunus (PRESIDENT) |
| Authorized Official Contact | 3526716741 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Pediatrics LLC 7960 Sw 60th Ave Ste 100 Ocala FL 34476-6457 Ph: (352) 671-6741 | Premier Pediatrics LLC 5388 S Us Highway 41 Dunnellon FL 34432-2042 Ph: (352) 671-6741 |
| NPI Number | 1891120960 |
|---|---|
| Provider Enumeration Date | 09/09/2013 |
| Last Update Date | 01/20/2023 |
| Certification Date | 01/20/2023 |
| Medicare PECOS PAC ID | 5294869236 |
|---|---|
| Medicare Enrollment ID | O20131031000618 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891120960 | NPI | - | NPPES |
| 003198506 | Medicaid | FL | |
| 003198508 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (NU) | Secondary |
| 208000000X | Pediatrics | (NU) | Primary |
| 208D00000X | General Practice | (NU) | Secondary |
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