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General NPI Number Information
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NPI Number | 1609412147
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Entity Type | Organization
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Legal Business Name | PREMIER HEALTH GROUP OF FLORIDA
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Dates
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Enumeration Date | 11/19/2019
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 7726 WINEGARD RD 2ND FLOOR SUITE 34
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City | ORLANDO
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State | FL
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Zip | 32809-7147
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Country | US
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Telephone | 407-729-2050
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Fax | 407-343-1966
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Provider Business Mailing Address
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Address Line | 7726 WINEGARD RD 2ND FLOOR SUITE 34
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City | ORLANDO
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State | FL
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Zip | 32809-7147
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Country | US
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Telephone | 407-729-2050
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Fax | 407-343-1966
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Authorized Official
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Title or Position | OWNER
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Name | CHOISETTE DAMUS
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Credential | APRN
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Telephone | 407-955-2324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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