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General NPI Number Information
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NPI Number | 1447684188
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Entity Type | Organization
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Legal Business Name | PREMIER CARE NURSES OF AMERICA INC
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 5350 W HILLSBORO BLVD STE 202
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4396
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Country | US
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Telephone | 954-933-9005
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Fax | 561-353-9201
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Provider Business Mailing Address
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Address Line | 5350 W HILLSBORO BLVD STE 202
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4396
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Country | US
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Telephone | 954-933-9005
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Fax | 561-353-9201
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MIRJANA GOFORTH
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Credential |
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Telephone | 561-353-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 30211191
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License Number State | FL
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