Premium Medical Center Corp
NPI #1053971937 in Virginia Gardens, Florida
Provider Information
- NPI Number
- 1053971937
- Entity Type
- Organization
- Organization Name
- Premium Medical Center Corp
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Jun 13, 2019
- Last Updated
- Jan 14, 2025
Practice Location
- Address
- 6405 NW 36TH ST STE 111
- City
- Virginia Gardens
- State
- Florida
- ZIP Code
- 33166-6977
- Phone
- (786) 334-5047
Authorized Official
- Name
- MR. DEIVYS GONZALEZ OLIVA
- Title
- AUTHORIZED OFFICIAL
- Phone
- (786) 334-5047
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
| Clinic/Center |
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