Premier Athletic Rehab Center LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT25977 Issued in FL

Legal business name

PREMIER ATHLETIC REHAB CENTER LLC

Practice address

3121 Ponce de Leon Blvd
Coral Gables, FL 33134-6816

Phone

(305) 396-9002

Fax

(305) 390-3003

NPI assigned

Apr 18, 2012

Organization subpart

No

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

Authorized official

Name

Alejandro G Gonzalez, DPTNPI 1760784987

Title

Physical Therapist

Phone

(305) 282-7252

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Alejandro Gabriel Gonzalez, DPT

  • Physical Therapist
  • Coral Gables, FL
  • NPI 1760784987
  Medicare reassignment Care Compare group NPD Authorized official
• Allison M Lacayo, PT, DPT

  • Physical Therapist
  • Peachtree City, GA
  • NPI 1275357451
  Care Compare group

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384819200000",
    "number": "1194082909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450844",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332450844",
            "telephone_number": "305-396-9002",
            "fax_number": "305-390-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331346816",
            "telephone_number": "305-396-9002",
            "fax_number": "305-390-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ATHLETIC REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2013-11-19",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "305-282-7252",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT25977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y07QR",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2801168",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Prashaw, RBT
• Precious Moments Services Corp
• Hannah Brooke Precour
• Preferred Medical Plan
• Premier Anesthesia Partners, LLC
• Premier Billing, Inc
• Premier Eye Care of Florida LLC
• Premier Physical Therapy LLC
• Premise Health of Florida Medical PA
• Milka T Premrl Rodriguez, L.M.T.,N.C.T.M.B.

• Physical Therapy Clinic/Center in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.