Organization
PREMIER CARE PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW CAMERON MINICK MD (PRESIDENT)
(813) 657-7337
Entity
Organization
Contact information
Practice address
16637 FISHHAWK BLVD, SUITE 101, LITHIA, FL 33547-3918
(813) 657-7337
(813) 661-4702
Mailing address
16637 FISHHAWK BLVD, SUITE 101, LITHIA, FL 33547-3918
(813) 657-7337
(813) 661-4702
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME90457
FL
Other
Enumeration date
06/01/2007
Last updated
08/22/2020
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