Premium Medical Center Corp

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

PREMIUM MEDICAL CENTER CORP

Practice address

6405 NW 36TH St Ste 11
Virginia Gardens, FL 33166-6974

Phone

(786) 334-5047

NPI assigned

Jun 14, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mabel Gutierrez Concepcion

Title

Owner

Phone

(786) 334-5047

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1053095463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 NW 36TH ST STE 11",
            "city": "VIRGINIA GARDENS",
            "state": "FL",
            "postal_code": "331666974",
            "telephone_number": "786-334-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 NW 36TH ST STE 11",
            "city": "VIRGINIA GARDENS",
            "state": "FL",
            "postal_code": "331666974",
            "telephone_number": "786-334-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM MEDICAL CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ CONCEPCION",
        "authorized_official_first_name": "MABEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-334-5047"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PP Medical Services, Inc.
• Prabhakar Podiatry LLC
• Prado Rehabilitation Inc
• Premier Health Services,Inc
• Premier Health Solutionjs
• Premium Medical Center Corp
• Prestigious Mental & Wellness Center
• Professional Rehabilitation Center Inc
• Professional Therapy Center, Inc
• Progressive Quality Care Corp

• Behavior Analyst in Virginia Gardens, FL
• Providers in Virginia Gardens, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.