NPIMap

Organization Active NPI

Premium Health Services Corporation

  • Home Health Agency
  • Miami, FL
National Provider Identifier
1366534406
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PREMIUM HEALTH SERVICES CORPORATION
Practice address
12002 SW 128TH CT
Suite 102
Miami, FL 33186-4639
Phone
(305) 971-0109
Fax
(305) 971-0520
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Authorized official

Name
Lazaro Polanco, RN
Title
Director of Nursing
Phone
(305) 971-0109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X FL Primary

Addresses

Primary practice location

12002 SW 128TH CT
Suite 102
Miami, FL 33186-4639

Mailing address

12002 SW 128TH CT
Suite 102
Miami, FL 33186-4639
Phone (305) 971-0109

National Provider Directory

National Provider Directory

Locations

12002 SW 128th Ct
Ste 102
Miami, FL 33186
Phone (305) 971-0109

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1366534406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12002 SW 128TH CT",
            "address_2": "SUITE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864639",
            "telephone_number": "305-971-0109",
            "fax_number": "305-971-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12002 SW 128TH CT",
            "address_2": "SUITE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864639",
            "telephone_number": "305-971-0109",
            "fax_number": "305-971-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM HEALTH SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "POLANCO",
        "authorized_official_first_name": "LAZARO",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "305-971-0109",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "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 Jul 16, 2007; 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.