Organization
PREMISE HEALTH OF FLORIDA MEDICAL, P.A.
Active
Other names
Liberty Medical
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN M.D. (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
10400 S US HIGHWAY 1, PORT SAINT LUCIE, FL 34952-5600
(772) 398-5651
(772) 337-4971
Mailing address
5500 MARYLAND WAY, BRENTWOOD, TN 37027-7048
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
11/22/2011
Last updated
08/15/2022
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