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Organization
PREMIERE PERINATAL ASSOCIATES
Active
Organization
PREMIERE PERINATAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERTRAM WALLS MD (OWNER/PRESIDENT)
(954) 838-2371
Entity
Organization
Contact information
Practice address
200 NW 7TH AVE, PREMIERE PERINATAL ASSOCIATES, FT LAUDERDALE, FL 33311-9026
(954) 759-6789
(919) 425-0478
Mailing address
500 SE 17TH ST, SUITE 100, FT LAUDERDALE, FL 33316-2547
(919) 425-1565
(919) 425-0478
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
ME43546
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273189401
—
FL
Enumeration date
05/08/2006
Last updated
09/17/2019
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