Organization
PREMIUM PRACTICE SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANG NGUYEN (OFFICE MANAGER)
(954) 428-2480
Entity
Organization
Contact information
Practice address
5340 N FEDERAL HWY STE 110, LIGHTHOUSE POINT, FL 33064-7058
(954) 428-2480
(954) 428-2904
Mailing address
5340 N FEDERAL HWY STE 110, LIGHTHOUSE POINT, FL 33064-7058
(954) 428-2480
(954) 428-2904
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME89279
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008600100
—
FL
01
—
FG672A
MEDICARE
FL
Enumeration date
03/29/2011
Last updated
10/25/2021
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