MEDICARE: PREMIUM CARE HEALTH SOLUTIONS CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1679314280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIUM CARE HEALTH SOLUTIONS CORP

Provider Business Mailing Address
First Line	:	10300 SW 72ND ST STE 184
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3002
Country	:	US
Telephone Number	:	786-646-0206
Fax Number	:

Provider Business Practice Location Address
First Line	:	10300 SW 72ND ST STE 184
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3002
Country	:	US
Telephone Number	:	786-646-0206
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIELA HEREDIA GONZALEZ
Credential	:
Telephone Number	:	786-646-0206

Provider Enumeration Date	:	06/06/2024
Last Update Date	:	06/06/2024

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Directions to “PREMIUM CARE HEALTH SOLUTIONS CORP ” Practice Location

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