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General NPI Number Information
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NPI Number | 1437599438
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Entity Type | Organization
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Legal Business Name | A&B PREMIER MEDICAL SERVICES
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Dates
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Enumeration Date | 07/05/2013
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Last Update Date | 07/05/2013
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Provider Practice Location Address
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Address Line | 10390 WASHINGTONIA PALM WAY APT 4424
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City | FORT MYERS
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State | FL
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Zip | 33966-7992
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Country | US
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Telephone | 239-244-1091
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Fax |
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Provider Business Mailing Address
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Address Line | 10390 WASHINGTONIA PALM WAY APT 4424
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City | FORT MYERS
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State | FL
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Zip | 33966-7992
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Country | US
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Telephone | 239-244-1091
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Fax |
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Authorized Official
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Title or Position | MANAGER MEMBER
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Name | MR. DOLAN ABU AOUF
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Credential | PA-C
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Telephone | 239-244-1091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9105138
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License Number State | FL
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