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General NPI Number Information
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NPI Number | 1104794353
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Entity Type | Organization
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Legal Business Name | PREMIERE CARE LLC
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 1244 WALDEN DR
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City | FORT MYERS
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State | FL
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Zip | 33901-8834
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Country | US
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Telephone | 904-479-8280
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Fax | 239-673-1625
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Provider Business Mailing Address
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Address Line | 1244 WALDEN DR
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City | FORT MYERS
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State | FL
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Zip | 33901-8834
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Country | US
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Telephone | 904-479-8280
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Fax | 239-673-1625
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Authorized Official
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Title or Position | MANAGER
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Name | TIFFANY D SCHOEN
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Credential | NP
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Telephone | 660-281-3975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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