Premiercardia PLLC

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

Legal business name

PREMIERCARDIA PLLC

Practice address

213 S US Highway 17 Ste a&B
East Palatka, FL 32131-4005

Phone

(904) 580-4730

Fax

(904) 580-4740

NPI assigned

May 4, 2021

Organization subpart

No

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

Authorized official

Name

Morhaf Ibrahim, MD

Title

Owner

Phone

(904) 580-4730

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1265015416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 BELFORT RD BLDG 400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566026",
            "telephone_number": "904-580-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S US HIGHWAY 17 STE A&B",
            "city": "EAST PALATKA",
            "state": "FL",
            "postal_code": "321314005",
            "telephone_number": "904-580-4730",
            "fax_number": "904-580-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERCARDIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "MORHAF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-580-4730",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.