MEDICARE: IMPRIMIS HEALTHGROUP LLC

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	302R00000X	Health Maintenance Organization

General Provider Information

NPI Number	:	1871796060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMPRIMIS HEALTHGROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 840407
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33084-2407
Country	:	US
Telephone Number	:	954-892-1926
Fax Number	:

Provider Business Practice Location Address
First Line	:	1210 NE 4 STREET
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33301-2407
Country	:	US
Telephone Number	:	954-892-1926
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. PHILIP CHRISTIAN
Credential	:	M.D.
Telephone Number	:	954-822-9597

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	08/22/2020

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Directions to “IMPRIMIS HEALTHGROUP LLC ” Practice Location

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