NPIMap

Organization Active NPI

Premium Healthcare Holdings, LLLP

  • Multi-Specialty Clinic/Center
  • Miami, FL
National Provider Identifier
1629786439
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMIUM HEALTHCARE HOLDINGS, LLLP
Practice address
6850 Coral Way
Miami, FL 33155-1758
Phone
(305) 265-4441
Fax
(305) 265-4844
NPI assigned
Nov 10, 2022
Organization subpart
Yes
Parent organization
PREMIUM HEALTHCARE HOLDINGS, LLLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Authorized official

Name
Keila Hoover, MDNPI 1417909375
Title
Owner
Phone
(305) 265-4441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

6850 Coral Way
Miami, FL 33155-1758

Mailing address

2400 SW 69TH Ave
Miami, FL 33155-2919
Phone (305) 265-4441

Other identifiers 1

IdentifierTypeStateIssuer
115232600MedicaidFL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2278302Premium Healthcare Holdings LLLP6850 Coral Way, Miami, FL 33155Certificate of waiverMar 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Premium Healthcare Holdings8 organizations share this tax ID, including this one
Part of
Premium Healthcare Holdings

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1629786439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 SW 69TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331552919",
            "telephone_number": "305-265-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 CORAL WAY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331551758",
            "telephone_number": "305-265-4441",
            "fax_number": "305-265-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM HEALTHCARE HOLDINGS, LLLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIUM HEALTHCARE HOLDINGS, LLLP",
        "enumeration_date": "2022-11-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "KEILA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-265-4441",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115232600",
            "state": "FL"
        }
    ],
    "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 May 10, 2023; 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.