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General NPI Number Information
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NPI Number | 1881502532
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Entity Type | Organization
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Legal Business Name | PREMISE HEALTH
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 1530 CELEBRATION BLVD
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City | KISSIMMEE
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State | FL
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Zip | 34747-5164
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Country | US
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Telephone | 407-934-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 1530 CELEBRATION BLVD
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City | KISSIMMEE
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State | FL
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Zip | 34747-5164
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Country | US
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Telephone | 407-934-4100
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Fax |
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Authorized Official
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Title or Position | EXERCISE PHYSIOLOGIST
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Name | WILLIAM LAM
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Credential | EP-C
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Telephone | 407-934-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State |
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