Organization Active NPI

Premium Care Doctors Corp.

  • Family Medicine Physician
  • Hialeah, FL
National Provider Identifier
1174695449
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PREMIUM CARE DOCTORS CORP.
Practice address
1816 E 4TH Ave
Hialeah, FL 33010-3115
Phone
(305) 805-0012
Fax
(305) 883-9003
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Authorized official

Name
Dr. Manuel Alfredo Galguera, MDNPI 1811978323
Title
President
Phone
(305) 805-0012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X

Addresses

Primary practice location

1816 E 4TH Ave
Hialeah, FL 33010-3115

Mailing address

1816 E 4TH Ave
Hialeah, FL 33010-3115
Phone (305) 805-0012

Other identifiers 1

IdentifierTypeStateIssuer
258699100MedicaidFL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1085088Premium Care Doctors Corp1816 East 4TH Ave, Hialeah, FL 33010Certificate of waiverJun 9, 2028

National Provider Directory

National Provider Directory

Locations

1816 E 4th Ave
Hialeah, FL 33010
Phone (305) 805-0012

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1174695449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 E 4TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330103115",
            "telephone_number": "305-805-0012",
            "fax_number": "305-883-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 E 4TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330103115",
            "telephone_number": "305-805-0012",
            "fax_number": "305-883-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM CARE DOCTORS CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "GALGUERA",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "ALFREDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-805-0012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258699100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.