Healthcare Provider Details

I. General information

NPI: 1144650714
Provider Name (Legal Business Name): PREMIER PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 06/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 CHIMNEY CORNER LN SUITE 2032
JUPITER FL
33458-4800
US

IV. Provider business mailing address

224 CHIMNEY CORNER LN SUITE 2032
JUPITER FL
33458-4800
US

V. Phone/Fax

Practice location:
  • Phone: 561-469-8989
  • Fax:
Mailing address:
  • Phone: 561-469-8989
  • Fax: 561-469-8988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME95676
License Number StateFL

VIII. Authorized Official

Name: SARRIE KATZ
Title or Position: OWNER/DOCTOR
Credential: M.D.
Phone: 561-469-8989