Organization
PREMIUM HEALTHCARE CENTER LLC
Active
Organization
PREMIUM HEALTHCARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVELICE LOZANO OLIVER (OWNER)
(786) 961-1592
Entity
Organization
Contact information
Practice address
9260 SW 72ND ST STE 207, MIAMI, FL 33173-3255
(786) 238-7057
(786) 803-8859
Mailing address
9260 SW 72ND ST STE 207, MIAMI, FL 33173-3255
(786) 238-7057
(786) 803-8859
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
09/18/2025
Last updated
08/22/2026
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