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Organization
PREMIER MEDICAL ASSOCIATES ALL FLORIDA, LLC
Active
Organization
PREMIER MEDICAL ASSOCIATES ALL FLORIDA, LLC
Active
Other names
Premier Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA ROMSKA (CREDENTIALING SPECIALIST)
(352) 259-2159
Entity
Organization
Contact information
Practice address
1580 SANTA BARBARA BLVD, SUITE C, THE VILLAGES, FL 32159
(352) 259-2159
(352) 259-5731
Mailing address
1580 SANTA BARBARA BLVD, THE VILLAGES, FL 32159-6827
(352) 259-2159
(352) 674-4386
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0069935
FL
207RN0300X
Nephrology Physician
ME95629
FL
363LA2200X
Adult Health Nurse Practitioner
ARNP3378652
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004699000
—
FL
01
—
K3300
PTAN
FL
Enumeration date
08/19/2006
Last updated
11/16/2022
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