| Premiermd Ipa, LLC | |
|
3465 Galt Ocean Drive 203 Fort Lauderdale FL 33308-7003 | |
| (954) 561-5135 | |
| (954) 561-5180 |
| Full Name | Premiermd Ipa, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3465 Galt Ocean Drive, Fort Lauderdale, Florida |
| Authorized Official Name and Position | David Fater (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 9545615135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premiermd Ipa, LLC 3465 Galt Ocean Drive 203 Fort Lauderdale FL 33308-7003 Ph: (954) 561-5135 | Premiermd Ipa, LLC 3465 Galt Ocean Drive 203 Fort Lauderdale FL 33308-7003 Ph: (954) 561-5135 |
| NPI Number | 1134536451 |
|---|---|
| Provider Enumeration Date | 07/18/2014 |
| Last Update Date | 07/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134536451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
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