Premier Cardiovascular Center, LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

PREMIER CARDIOVASCULAR CENTER, LLC

Practice address

450 W State Road 434 Ste 2010
Longwood, FL 32750-5187

Phone

(407) 767-8200

NPI assigned

Sep 16, 2020

Organization subpart

No

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

Authorized official

Name

Andy Jordan

Title

Credentialing Coordinator

Phone

(321) 206-8100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1437765443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W STATE ROAD 434 STE 2010",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W STATE ROAD 434 STE 2010",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505187",
            "telephone_number": "407-767-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CARDIOVASCULAR CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "321-206-8100"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda M Poumakis
• Julie A Povlick, PHARMD, CDM
• Laura Ann Powell, LMHC
• Devyn Jeanne Prado, MA, CCC-SLP
• Prem K Kathuria PA
• Lucee Price, LMHC
• Prime MD Care LLC
• Shahied Primm, OT/L
• Kristen Elizabeth Pringle
• Mylika Pritchett, PMHNP-BC/FNP-BC

• Cardiovascular Disease Physician in Longwood, FL
• Providers in Longwood, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.