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General NPI Number Information
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NPI Number | 1508969536
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Entity Type | Organization
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Legal Business Name | PREMIER TOTAL HEALTHCARE INC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 2415 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6605
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Country | US
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Telephone | 954-456-0250
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Fax | 954-456-0820
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Provider Business Mailing Address
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Address Line | 2415 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6605
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Country | US
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Telephone | 954-456-0250
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Fax | 954-456-0820
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Authorized Official
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Title or Position | DC
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Name | KEVIN P MCGRATH
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Credential |
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Telephone | 954-456-0250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | OS5537
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH7202
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS5537
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License Number State | FL
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