Healthcare Provider Details

I. General information

NPI: 1780588012
Provider Name (Legal Business Name): PREMIUM HEALTH COMPANION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

8920 NW 162ND TER
MIAMI LAKES FL
33018-6108
US

IV. Provider business mailing address

8920 NW 162ND TER
MIAMI LAKES FL
33018-6108
US

V. Phone/Fax

Practice location:
  • Phone: 305-318-8417
  • Fax:
Mailing address:
  • Phone: 305-318-8417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name: CATHERINE LLARENA
Title or Position: OWNER
Credential: MGR
Phone: 305-318-8417