| Premium Practice Solutions, Llc | |
|
5340 N Federal Hwy Ste 110 Lighthouse Point FL 33064-7058 | |
| (954) 428-2480 | |
| (954) 428-2904 |
| Full Name | Premium Practice Solutions, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5340 N Federal Hwy Ste 110, Lighthouse Point, Florida |
| Authorized Official Name and Position | Hang Nguyen (OFFICE MANAGER) |
| Authorized Official Contact | 9544282480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premium Practice Solutions, Llc 5340 N Federal Hwy Ste 110 Lighthouse Point FL 33064-7058 Ph: (954) 428-2480 | Premium Practice Solutions, Llc 5340 N Federal Hwy Ste 110 Lighthouse Point FL 33064-7058 Ph: (954) 428-2480 |
| NPI Number | 1164711214 |
|---|---|
| Provider Enumeration Date | 03/29/2011 |
| Last Update Date | 10/25/2021 |
| Medicare PECOS PAC ID | 1456520949 |
|---|---|
| Medicare Enrollment ID | O20110818000467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164711214 | NPI | - | NPPES |
| 008600100 | Medicaid | FL | |
| FG672A | Other | FL | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | ME89279 (Florida) | Primary |
| Provider Name | Vipin Gupta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912091794 PECOS PAC ID: 2163320979 Enrollment ID: I20050722000531 |
| Provider Name | Donald J Zeller |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1154360733 PECOS PAC ID: 7618003815 Enrollment ID: I20100326000650 |
| Provider Name | Mayuri P Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114075785 PECOS PAC ID: 9638347289 Enrollment ID: I20110726000319 |
| Provider Name | Eduardo Quintero Nazario |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306133988 PECOS PAC ID: 8426329947 Enrollment ID: I20211208002102 |
| Provider Name | James Radke |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1518953025 PECOS PAC ID: 0547323610 Enrollment ID: I20230215000410 |
Amal Hanna M D P A Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3170 N Federal Hwy, Ste 212, Lighthouse Point, FL 33064 Phone: 954-943-0088 | |
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