Healthcare Provider Details

I. General information

NPI: 1760117618
Provider Name (Legal Business Name): PRIME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 SW 117TH AVE STE C205
MIAMI FL
33186-2185
US

IV. Provider business mailing address

8900 SW 117TH AVE STE C205
MIAMI FL
33186-2185
US

V. Phone/Fax

Practice location:
  • Phone: 833-200-5388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: VICTOR CRUZ
Title or Position: MANAGER
Credential:
Phone: 833-200-5388