Organization
PREMIER HEALTH PLUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY G HERNANADEZ APRN (OWNER)
(941) 347-8912
Entity
Organization
Contact information
Practice address
3691 TAMIAMI TRL, PUNTA GORDA, FL 33950-7228
(941) 347-8912
Mailing address
3691 TAMIAMI TRL, PUNTA GORDA, FL 33950-7228
(941) 347-8912
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN9335689
LICENSE
FL
Enumeration date
10/06/2021
Last updated
01/20/2022
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