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PREMIERE MEDICAL GROUP PA NPI 1285813147


NPI Information

NPI: 1285813147
Provider Name: PREMIERE MEDICAL GROUP PA
Classification: General Acute Care Hospital - 282N00000X
Entity Type: Organization

CLIA Number: 10D2005721

Address:
2107 DAIRY RD
MELBOURNE, FL
ZIP 32904
Phone: (321) 676-7860
Get Directions

PREMIERE MEDICAL GROUP PA is a general acute care hospital in Melbourne, FL. The provider is an acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. PREMIERE MEDICAL GROUP PA NPI is 1285813147. The provider is registered as an organization entity type.

The provider's business location address is:

2107 DAIRY RD
MELBOURNE, FL
ZIP 32904-209
Phone: (321) 676-7860
Fax: (321) 956-8225

The provider's authorized official is Miguel L Lorente .
The authorized official title is Owner and has the following contact phone number (321) 676-7860.

The CLIA number assigned to this NPI record is 10D2005721 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/29/2007 and was last updated on 10/13/2010.


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
1282N00000XGeneral Acute Care HospitalME82880FLORIDAYes

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
1H24300MEDICARE UPINFLORIDA
2262684500MEDICAIDFLORIDA
3K4153MEDICARE PINFLORIDA

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: 5/5/2024

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