Healthcare Provider Details

I. General information

NPI: 1366346843
Provider Name (Legal Business Name): PREMIER FAMILY CARE CLINIC FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 W HIGHWAY 4
CENTURY FL
32535-3503
US

IV. Provider business mailing address

55621 LOTTIE RD
PERDIDO AL
36562-3025
US

V. Phone/Fax

Practice location:
  • Phone: 251-626-6575
  • Fax: 251-626-6758
Mailing address:
  • Phone: 251-626-6757
  • Fax: 251-626-6758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: KELLY CAY LAMBETH
Title or Position: OWNER
Credential: CRNP
Phone: 251-626-6757