NPI 1154807352

Premiermd Ipa Healthcare, LLC

Organisation Exclusive Provider Organization Ft Lauderdale, FL

Practice location

Address: 3465 Galt Ocean Dr STE 204, Ft Lauderdale, FL 33308-7077
Phone: (954) 561-5135
Fax: (954) 252-2565

Authorised official

Name: Victor Toledano
Title: President
Phone: (954) 561-5135

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

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Registry record

NPI: 1154807352
Entity type: Organization
NPI issued: 11 Jul 2018
Record last updated: 11 Jul 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.