Healthcare Provider Details

I. General information

NPI: 1841847597
Provider Name (Legal Business Name): PREMIER MEDICAL CONCIERGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9655 TAMIAMI TRL N STE 202
NAPLES FL
34108-2796
US

IV. Provider business mailing address

9655 TAMIAMI TRL N STE 202
NAPLES FL
34108-2796
US

V. Phone/Fax

Practice location:
  • Phone: 239-249-4191
  • Fax: 239-631-6872
Mailing address:
  • Phone: 239-249-4191
  • Fax: 239-631-6872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH PAUL BANDEIRA
Title or Position: OWNER/MANAGER
Credential: MD
Phone: 239-249-4191