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Organization
PREMIERMD IPA, LLC
Active
Organization
PREMIERMD IPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FATER COO (CHIEF OPERATING OFFICER)
(954) 561-5135
Entity
Organization
Contact information
Practice address
3465 GALT OCEAN DRIVE, 203, FORT LAUDERDALE, FL 33308-7003
(954) 561-5135
(954) 561-5180
Mailing address
3465 GALT OCEAN DRIVE, 203, FORT LAUDERDALE, FL 33308-7003
(954) 561-5135
(954) 561-5180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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