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PREMIER CARE PEDIATRICS PA NPI 1346442506


NPI Information

NPI: 1346442506
Provider Name: PREMIER CARE PEDIATRICS, PA
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 10D1055352

Address:
16637 FISHHAWK BLVD
SUITE 101
LITHIA, FL
ZIP 33547
Phone: (813) 657-7337
Get Directions

PREMIER CARE PEDIATRICS, PA is a pediatrics in Lithia, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. PREMIER CARE PEDIATRICS, PA NPI is 1346442506. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16637 FISHHAWK BLVD
SUITE 101
LITHIA, FL
ZIP 33547-918
Phone: (813) 657-7337
Fax: (813) 661-4702

The provider's authorized official is Matthew Cameron Minick .
The authorized official title is President and has the following contact phone number (813) 657-7337.

The CLIA number assigned to this NPI record is 10D1055352 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/1/2007 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsME90457FLORIDAYes

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: 4/28/2024

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