Premiermd Ipa Healthcare, LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

PREMIERMD IPA HEALTHCARE, LLC

Practice address

3465 Galt Ocean Dr Ste 204
Ft Lauderdale, FL 33308-7077

Phone

(954) 561-5135

Fax

(954) 252-2565

NPI assigned

Jul 11, 2018

Organization subpart

No

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

Authorized official

Name

Victor Toledano, MDNPI 1689772535

Title

President

Phone

(954) 561-5135

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victor Toledano, M.D.

  • Internal Medicine Physician
  • Ft Lauderdale, FL
  • NPI 1689772535
  NPD (past) Authorized official

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531267200000",
    "number": "1154807352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 GALT OCEAN DR STE 204",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333087077",
            "telephone_number": "954-561-5135",
            "fax_number": "954-252-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3465 GALT OCEAN DR STE 204",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333087077",
            "telephone_number": "954-561-5135",
            "fax_number": "954-252-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERMD IPA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-11",
        "status": "A",
        "authorized_official_last_name": "TOLEDANO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-561-5135",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Premiermd Quality Care LLC
• Premiermd Sim, LLC

• Exclusive Provider Organization in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.