Healthcare Provider Details

I. General information

NPI: 1962835744
Provider Name (Legal Business Name): PREMIER CARE NURSES OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 NW BOCA RATON BLVD STE 204
BOCA RATON FL
33431-6709
US

IV. Provider business mailing address

2799 NW BOCA RATON BLVD STE 204
BOCA RATON FL
33431-6709
US

V. Phone/Fax

Practice location:
  • Phone: 561-353-9200
  • Fax:
Mailing address:
  • Phone: 561-353-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number30211060
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MIRJANA GOFORTH
Title or Position: ADMINISTRATOR
Credential:
Phone: 561-353-9200