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General NPI Number Information
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NPI Number | 1710879515
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Entity Type | Organization
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Legal Business Name | MEDSTATION PREMIUM LLC
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 900 E ATLANTIC BLVD
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City | POMPANO BEACH
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State | FL
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Zip | 33060-7584
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Country | US
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Telephone | 954-433-6531
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Fax |
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Provider Business Mailing Address
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Address Line | 3402 N ANDREWS AVENUE EXT
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City | POMPANO BEACH
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State | FL
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Zip | 33064-2067
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. NEYMAR CABRAL DE LIMA
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Credential |
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Telephone | 954-433-6531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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