Premiere Perinatal Associates

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

ME43546 Issued in FL

Legal business name

PREMIERE PERINATAL ASSOCIATES

Practice address

200 NW 7TH Ave
Premiere Perinatal Associates
Ft Lauderdale, FL 33311-9026

Phone

(954) 759-6789

Fax

(919) 425-0478

NPI assigned

May 8, 2006

Last updated

Sep 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bertram Walls, MD

Title

Owner/President

Phone

(954) 838-2371

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Florida Em-I Medical Services PA

  • Physician Assistant
  • Brooksville, FL
  • NPI 1578746574

  Member Of

  NPD member

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1417906561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SE 17TH ST",
            "address_2": "SUITE 100",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162547",
            "telephone_number": "919-425-1565",
            "fax_number": "919-425-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NW 7TH AVE",
            "address_2": "PREMIERE PERINATAL ASSOCIATES",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333119026",
            "telephone_number": "954-759-6789",
            "fax_number": "919-425-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE PERINATAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "BERTRAM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "954-838-2371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "FL",
            "license": "ME43546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273189401",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Precision Pathway Therapy Group Corp
• Prefered Medical Equipment Supply
• Preferred Educational & Psychological Services, Inc
• Premier Smile Center
• Premier Spine Center,Inc
• Premiere Perinatal Associates PA
• Premiere Perinatal Associates PA
• Premiermd Care Network LLC
• Premiermd Ipa Healthcare, LLC
• Premiermd Ipa, LLC

• Maternal & Fetal Medicine Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Maternal & Fetal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.