Premier Neuro Therapy LLC

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

Legal business name

PREMIER NEURO THERAPY LLC

Practice address

14255 Beach Blvd
Jacksonville, FL 32250-1576

Phone

(904) 470-0673

NPI assigned

Apr 4, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Zachary Michael

Title

Coo/Cfo

Phone

(717) 357-2349

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1770016115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13700 SUTTON PARK DR N",
            "address_2": "APT. 816",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242273",
            "telephone_number": "904-470-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14255 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501576",
            "telephone_number": "904-470-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER NEURO THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "COO/CFO",
        "authorized_official_telephone_number": "717-357-2349",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Premier Open MRI Center, L.C.
• Premier Pharmacy of Jacksonville Inc
• Premier Physical Therapy and Rehabilitation of Jacksonville, Inc
• Premier Physical Therapy and Rehabilitation of Jacksonville, Inc
• Premier Physical Therapy and Rehabilitation of Jacksonville, Inc.

• Other Specialist/Technologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Other Specialist/Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.