Provider Demographics
NPI:1679314280
Name:PREMIUM CARE HEALTH SOLUTIONS CORP
Entity type:Organization
Organization Name:PREMIUM CARE HEALTH SOLUTIONS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEREDIA GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-646-0206
Mailing Address - Street 1:10300 SW 72ND ST STE 184
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3002
Mailing Address - Country:US
Mailing Address - Phone:786-646-0206
Mailing Address - Fax:
Practice Address - Street 1:10300 SW 72ND ST STE 184
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3002
Practice Address - Country:US
Practice Address - Phone:786-646-0206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies