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Organization
PREMIER CARDIO PULMONARY MEDICAL INC
Active
Organization
PREMIER CARDIO PULMONARY MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY A JOHNS (PRESIDENT)
(727) 287-2784
Entity
Organization
Contact information
Practice address
2194 MAIN ST, SUITE I, DUNEDIN, FL 34698-5696
(727) 287-2784
(727) 669-9260
Mailing address
PO BOX 16264, CLEARWATER, FL 33766-6264
(727) 287-2784
(727) 669-9260
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ6542
RAILROAD MEDICARE
FL
01
—
X1565
BCBS
FL
Enumeration date
04/06/2006
Last updated
10/27/2008
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