PREMIERE MEDICAL GROUP PA (NPI# 1285813147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285813147 |
| Entity Type | Organization |
| Organization Name | PREMIERE MEDICAL GROUP PA |
| Practice Address |
2107 Dairy Rd Melbourne FL 32904-5209 |
| Mailing Address |
Po Box 120043 West Melbourne FL 32912-0043 |
| Practice Telephone | 3216767860 |
| Practice Fax Number | 3219568225 |
| Mailing Telephone | 3216767860 |
| Mailing Fax Number | 3219527224 |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2010-10-13 |
| Authorized Official Name | DR. MIGUEL L LORENTE (OWNER) |
| Authorized Official Telephone | 3216767860 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | ME82880 | FL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 262684500 | 05 |
| Street Address |
2107 DAIRY RD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32904-5209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164448072 | Miguel Lynn Lorente | Legal Medicine | 2107 Dairy Rd, Melbourne, FL 32904-5209 | 2006-07-14 |
| 1740504455 | Physician Associates LLC | Internal Medicine | 2107 Dairy Rd, Melbourne, FL 32904-5209 | 2010-03-24 |
| 1265765531 | Dairy Road Urgent Care LLC | Clinic/Center | 2107 Dairy Rd, Melbourne, FL 32904-5209 | 2009-09-17 |
| 1922172485 | Tiffany Noel Carillet | Physician Assistant | 2107 Dairy Rd, Melbourne, FL 32904-5241 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063066512 | Shepherd's Heart Ministries | Counselor | 900 S Wickham Rd, Melbourne, FL 32904 | 2019-08-01 |
| 1588138663 | Nicholle C Rothengass | Physician Assistant | 2263 W New Haven Ave # 350, W Melbourne, FL 32904 | 2019-01-11 |
| 1114407020 | Natalie Havkin | Speech-Language Pathologist | 250 S Wickham Rd., Melbourne, FL 32904 | 2018-08-20 |
| 1184119299 | Marni B Simon | Speech-Language Pathologist | 565 Acacia Ave, Melbourne Village, FL 32904 | 2018-06-30 |
| 1821588625 | Walden Psychological Services, LLC | Psychologist | 3400 Willowwood Dr, Melbourne, FL 32904 | 2018-05-16 |
| 1598276271 | Donetta Gwin Reynolds | Early Intervention Provider Agency | 764 Triples Crown Lane, West Melbourne, FL 32904 | 2017-10-20 |
| 1598205221 | Marathon Health, LLC | General Practice | 2550 Wingate Boulevard, C/o Brevard Wellcare- South, West Melbourne, FL 32904 | 2017-02-28 |
| 1366875387 | Cancer Center of Melbourne LLC | Clinic/Center | 415 S. Wickham Rd., Melbourne, FL 32904 | 2013-08-13 |
| 1558704312 | Sandra Suzanne Borthwick | Social Worker | 569 Sylvia Rd, Melbourne, FL 32904 | 2013-04-11 |
| 1396983607 | Genesis | Skilled Nursing Facility | 2653 Reflections Pl, W. Melbourne, FL 32904 | 2009-01-23 |
| Find all providers in zip 32904 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386925618 | Animal Hospital of Central Brevard Inc | General Acute Care Hospital | 4521 N Wickham Rd Ste 102, Melbourne, FL 32935-7108 | 2011-08-31 |
| 1518909811 | Vista | General Acute Care Hospital | 2423 King Richard Rd, Melbourne, FL 32935-2930 | 2006-06-12 |
| 1356845481 | Medical Applications and Services | General Acute Care Hospital | 1350 Hickory St, Melbourne, FL 32901-3224 | 2018-03-22 |
| 1801320718 | Steward Melbourne Hospital, Inc. | General Acute Care Hospital | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2017-04-18 |
| 1730494816 | Viera Hospital, Inc. | General Acute Care Hospital | 8745 N Wickham Rd, Attention: Administration, Melbourne, FL 32940-5997 | 2010-08-12 |
| 1295987691 | James E Holmes Regional Hospital | General Acute Care Hospital | 1350 S Hickory St, Melbourne, FL 32901-3224 | 2008-10-16 |
| 1780835702 | James E Holmes Regional Hospital | General Acute Care Hospital | 1350 S Hickory St, Melbourne, FL 32901-3224 | 2008-10-08 |
| 1295702728 | Holmes Regional Medical Center, Inc. | General Acute Care Hospital | 1350 Hickory St, Melbourne, FL 32901-3224 | 2006-03-03 |
| 1962497198 | Melbourne Hma, LLC | General Acute Care Hospital | 250 N Wickham Rd, Melbourne, FL 32935-8625 | 2005-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193664 | Central Florida Health Services, LLC | General Acute Care Hospital | 6700 Lake Nona Blvd, Orlando, FL 32827-7729 | 2020-10-29 |
| 1639783509 | Public Health Trust of Miami Dade County Florida | General Acute Care Hospital | 2801 Nw 79th Ave, Doral, FL 33122-1174 | 2020-09-08 |
| 1013534445 | Sarasota Memorial Hospital | General Acute Care Hospital | 2600 Laurel Rd E, North Venice, FL 34275-3226 | 2020-07-01 |
| 1528683257 | Gainesville Vamc | General Acute Care Hospital | 2080 Child St Bldg 200h, Jacksonville, FL 32214-5005 | 2020-06-09 |
| 1184246894 | Zbeiro Corp | General Acute Care Hospital | 13952 Sw 52nd Ln, Miami, FL 33175-5166 | 2020-05-15 |
| 1962053728 | Optimum Care Medical Group | General Acute Care Hospital | 10520 Alcon Blue Dr, Riverview, FL 33578-4116 | 2019-09-24 |
| 1003465097 | Medical Center of Deltona, Inc. | General Acute Care Hospital | 3300 Halifax Crossings Blvd., Deltona, FL 32725 | 2019-09-11 |
| 1437652500 | Physicians On Call I Corp | General Acute Care Hospital | 10081 Pines Blvd Ste B, Pembroke Pines, FL 33024-6171 | 2018-03-14 |
| 1396272589 | Sacred Heart Hospital | General Acute Care Hospital | 2552 Carmel Heights Rd, Pensacola, FL 32504 | 2017-05-18 |
| 1659803435 | Palmetto General Hosptial | General Acute Care Hospital | 2001 West 68th St, Suite 202, Hialeah, FL 33016 | 2017-03-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.