PREMIER ENDOCRINOLOGY PLLC NPI 1033487426

NPI Information

NPI: 1033487426
Provider Name: PREMIER ENDOCRINOLOGY PLLC
Classification: Internal Medicine - 207RE0101X
Entity Type: Organization

Specialization: Endocrinology, Diabetes & Metabolism

CLIA Number: 10D2033700

Address:
3004 17TH ST
SAINT CLOUD, FL
ZIP 34769
Phone: (407) 593-2910
Get Directions

PREMIER ENDOCRINOLOGY PLLC is an endocrinology and diabetes and metabolism internal medicine in Saint Cloud, FL. The provider is an internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. PREMIER ENDOCRINOLOGY PLLC NPI is 1033487426. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3004 17TH ST
SAINT CLOUD, FL
ZIP 34769-011
Phone: (407) 593-2910
Fax: (407) 593-2913

The provider's authorized official is Theresa Adadzewa Fynn .
The authorized official title is Owner and has the following contact phone number (407) 593-2910.

The CLIA number assigned to this NPI record is 10D2033700 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/13/2011 and was last updated on 7/28/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	ME109189	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	12316257	OTHER		CAQH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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