Healthcare Provider Details

I. General information

NPI: 1790689800
Provider Name (Legal Business Name): PREMIER PRIMARY CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 NE 14TH STREET CSWY STE 2
POMPANO BEACH FL
33062-3535
US

IV. Provider business mailing address

2701 NE 14TH STREET CSWY STE 2
POMPANO BEACH FL
33062-3535
US

V. Phone/Fax

Practice location:
  • Phone: 954-824-1764
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CAMILLE A. MCDONALD-TOUSSAINT
Title or Position: CEO
Credential:
Phone: 954-824-1764