| Premium Medical Associates Healthcare Llc | |
|
600 W College Ave Tallahassee FL 32306 | |
| (407) 498-6934 | |
| (407) 386-7878 |
| Full Name | Premium Medical Associates Healthcare Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 W College Ave, Tallahassee, Florida |
| Authorized Official Name and Position | Lyne Pierre (BUSINESS PARTNER) |
| Authorized Official Contact | 4078601511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premium Medical Associates Healthcare Llc 4651 Babcock St Ne Ste 18 Palm Bay FL 32905-2808 Ph: (407) 498-6934 | Premium Medical Associates Healthcare Llc 600 W College Ave Tallahassee FL 32306 Ph: (407) 498-6934 |
| NPI Number | 1306413927 |
|---|---|
| Provider Enumeration Date | 06/10/2021 |
| Last Update Date | 06/10/2021 |
| Medicare PECOS PAC ID | 3971905506 |
|---|---|
| Medicare Enrollment ID | O20210706001198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306413927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Lyne G Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093055659 PECOS PAC ID: 3375778426 Enrollment ID: I20131028001327 |
| Provider Name | Rose Maxime |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700242468 PECOS PAC ID: 2365748050 Enrollment ID: I20160307000598 |
| Provider Name | Adriana Bentum-tilus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801330519 PECOS PAC ID: 7012291198 Enrollment ID: I20170309001645 |
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