NPIMap

Organization Active NPI

Premium Healthcare Holdings, LLLP

  • Diagnostic Radiology Physician
  • Miami, FL
National Provider Identifier
1194434662
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PREMIUM HEALTHCARE HOLDINGS, LLLP
Practice address
12905 SW 42ND St Ste 106
Miami, FL 33175-2910
Phone
(305) 229-2020
Fax
(305) 229-2218
NPI assigned
Nov 23, 2022
Organization subpart
Yes
Parent organization
PREMIUM HEALTHCARE HOLDINGS, LLLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Keila HooverNPI 1417909375
Title
Owner
Phone
(305) 265-4441

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

12905 SW 42ND St Ste 106
Miami, FL 33175-2910

Mailing address

2400 SW 69TH Ave
Miami, FL 33155-2919
Phone (305) 265-4441

National Provider Directory

National Provider Directory
Tax ID family
Premium Healthcare Holdings8 organizations share this tax ID, including this one
Part of
Premium Healthcare Holdings

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1669161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1194434662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 SW 69TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331552919",
            "telephone_number": "305-265-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12905 SW 42ND ST STE 106",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331752910",
            "telephone_number": "305-229-2020",
            "fax_number": "305-229-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM HEALTHCARE HOLDINGS, LLLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIUM HEALTHCARE HOLDINGS, LLLP",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "KEILA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-265-4441"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.