Organization
PREMIUM CARE HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUISA RONDON-LASSEN (ADMINISTRATOR)
(305) 336-6275
Entity
Organization
Contact information
Practice address
10300 SW 72ND ST STE 200, MIAMI, FL 33173-3040
(305) 336-6275
(786) 254-5162
Mailing address
10300 SW 72ND ST STE 200, MIAMI, FL 33173-3040
(305) 336-6275
(786) 254-5162
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
299995289
AHCA
FL
Enumeration date
06/21/2021
Last updated
05/13/2022
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