Premiere Medical Group PA

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

ME82880 Issued in FL

Legal business name

PREMIERE MEDICAL GROUP PA

Practice address

2107 Dairy Rd
Melbourne, FL 32904-5209

Phone

(321) 676-7860

Fax

(321) 956-8225

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Miguel L Lorente, M.D.NPI 1164448072

Title

Owner

Phone

(321) 676-7860

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Miguel Lynn Lorente, M.D.

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1164448072
  NPD (past) Authorized official

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1285813147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120043",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329120043",
            "telephone_number": "321-676-7860",
            "fax_number": "321-952-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 DAIRY RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329045209",
            "telephone_number": "321-676-7860",
            "fax_number": "321-956-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "LORENTE",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-676-7860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "ME82880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262684500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prefix Suffix LLC
• Cherryl Ann Premdass, M.D.
• Premier Orthotics & Prosthetics, LLC
• Premier Physical Therapy & Sports Medicine
• Premier Urgent Care of Brevard LLC
• Brendan Michael Prendergast, M.D.
• Christopher Thomas Prendergast, R.PH
• Lindsay Jane Prendergast
• Rachel Prendergast, LCSW
• Presgar Imaging of Rockledge LLC

• General Acute Care Hospital in Melbourne, FL
• Providers in Melbourne, FL by specialty
• General Acute Care Hospital in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.