PREMIUM HEALTH GROUP CLINIC LLC (NPI# 1558929752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558929752 |
| Entity Type | Organization |
| Organization Name | PREMIUM HEALTH GROUP CLINIC LLC |
| Practice Address |
Laguna Gardens Shopping Center Suite 101a Carolina PR 00979 |
| Practice Telephone | 7874444908 |
| Mailing Telephone | 7874444908 |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2020-05-07 |
| Authorized Official Name | LUZ VILLANUEVA (CEO) |
| Authorized Official Telephone | 7872531101 |
| Is Organization Subpart | Y |
| Parent Organization Name | PREMIUM HEALTH GROUP CLINIC LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871115279 | Premium Health Group Clinic LLC | Clinic/Center | Laguna Gardens Shopping Center, Suite 101-a, Carolina, PR 00979 | 2020-05-08 |
| Street Address |
LAGUNA GARDENS SHOPPING CENTER SUITE 101A |
| City | CAROLINA |
| State | PR |
| Zip Code | 00979 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215029046 | Gustavo Rivera Cruz | Psychiatry & Neurology | Laguna Gardens Shopping Center, Suite 211, Carolina, PR 00979 | 2006-09-29 |
| 1487251492 | Leonardo R Diaz | Nutritionist | Laguna Gardens Shopping Center, Suite 101-a, Carolina, PR 00979 | 2020-10-02 |
| 1871115279 | Premium Health Group Clinic LLC | Clinic/Center | Laguna Gardens Shopping Center, Suite 101-a, Carolina, PR 00979 | 2020-05-08 |
| 1841686524 | Laboratorio Clinico M. Landron, Inc. | Clinical Medical Laboratory | Laguna Gardens Shopping Center, Suite 208, Carolina, PR 00981 | 2015-04-09 |
| 1629315650 | Dayra D Quiles-perez | Psychologist | Laguna Gardens Shopping Center, Suite 249-2, Carolina, PUERTO RICO 00979 | 2013-01-10 |
| 1447519988 | Prodessional Audio Services, Inc. | Preferred Provider Organization | Laguna Gardens Shopping Center, Suite 248, Carolina, PR 00979-6525 | 2012-05-03 |
| 1497023592 | Laguna Gardens Radiology and Imaging Group Inc. | Clinic/Center | Laguna Gardens Shopping Center, Suite 106, Carolina, PR 00979-6425 | 2011-12-05 |
| 1306071451 | Premium Health Group Clinic | Clinic/Center | Laguna Gardens Shopping Center, Suite 101a, Carolina, PR 00979 | 2009-05-19 |
| 1164682456 | Physiatric and Emergency Health Services Psc | Physical Medicine & Rehabilitation | Laguna Gardens Shopping Center, Suite 116 Primer Nivel, Carolina, PR 00985 | 2008-06-11 |
| 1083830970 | Norberto Medina Pellicer | Dentist | Laguna Gardens Shopping Center, Suite 200, Carolina, PR 00979 | 2007-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437769254 | Irma Cristina Acevedo | Psychologist | St. Palma De Sombrero #2, Urb. Villas Del Palmar Sur, Carolina, PR 00979 | 2020-08-06 |
| 1306468145 | Celia Rivera | Social Worker | 42 Calle Lucero, Urb. Los Angeles, Carolina, PR 00979 | 2020-05-14 |
| 1659922771 | Neyda Rosa Estremera | Technician | Condomino Waldorf Towers Apt. 1202, 4123 Ave. Isla Verde, Carolina, PR 00979 | 2019-09-20 |
| 1891351417 | Cesar G. Gerena Candal | General Practice | 1906 Cond Mundo Feliz, Carolina, PR 00979 | 2019-05-20 |
| 1770054298 | Movitaxi | Ambulance | 5870 Calle Tartak Apart 2104, Condominio Costa Del Sol, Carolina, PR 00979 | 2018-12-10 |
| 1720569973 | Soobin Maeng | General Practice | Condominio Playa Dorada Torres B Ph 12, Carolina, PR 00979 | 2018-08-26 |
| 1780170514 | Mayelin Amoros Duquesne | Internal Medicine | 5347 Ave Isla Verde, Marbella Oeste 1814, Carolina, PR 00979 | 2018-07-04 |
| 1851886741 | Carl L Palermo | Independent Medical Examiner | 7041 Calle 187 Apt 609a, Carolina, PR 00979 | 2018-06-25 |
| 1548753338 | Carol Stephanie Gonzalez | Psychologist | Isla Verde Mall, Avenida Los Gobernadores, Suite 218, Carolina, PR 00979 | 2018-06-07 |
| 1104323906 | Hospitalist Medical Services, Psc | Anesthesiology | Edificio Jesus T Pinero Ave Fernandez Juncos Bo Pueblo, Carolina, PR 00979 | 2018-04-09 |
| Find all providers in zip 00979 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609136506 | Rad Imaging Services LLC | Radiology | 5349 Ave Isla Verde, Marbella East Apt 1603, Carolina, PR 00979-5500 | 2012-05-24 |
| 1205113388 | Medsci Diagnostics Inc | Radiology | 65 Infanteria Ave Interseccion Carr 887, Barrio San Anton, Carolina, PR 00986 | 2011-11-03 |
| 1407175383 | Jose Antonio Berllingeri | Radiology | 4837 Ave Isla Verde, Apt. 1109, Carolina, PR 00979-5418 | 2010-05-18 |
| 1891833240 | Enrique Agustin Padro I | Radiology | E17 Calle Malaga, Vistamar Marina, Carolina, PR 00983-1507 | 2007-02-01 |
| 1457450207 | Carmen S Caban Espinosa | Radiology | Carolina Ct & Breast Clinic, Carolina Shopping Court Suite 023a, Carolina, PR 00985 | 2006-09-21 |
| 1932208782 | Sonia Dones Rodriguez | Radiology | Carolina Ct and Breast Clinic, Carolina Shopping Court Suite 023a, Carolina, PR 00985 | 2006-09-21 |
| 1144282161 | Carolina Imaging Center | Radiology | A4 Calle 4, Villa Fontana, Carolina, PR 00985-5208 | 2006-04-05 |
| 1720075120 | Monserrate Imaging Center Psc | Radiology | Avenida Monserra Ba 25, Carolina, PR 00983 | 2005-09-30 |
| 1033272349 | Recinto De Ciencias Medicas | Radiology | Ave. 65 De Infanteria, Carr. # 3 Km. 8.3, Carolina, PR 00984 | 2006-12-18 |
| 1255402871 | Juan A Torres Torres | Radiology | Carolina Ct & Breast Clinic, Carolina Shopping Court Suite 023a, Carolina, PR 00985 | 2006-11-13 |
| Find all providers in CAROLINA | ||||
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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.