NPIMap

Organization Active NPI

Premier Pediatrics, LLC

  • Pediatrics Physician
  • Ocala, FL
National Provider Identifier
1831525930
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME96086 Issued in FL
Legal business name
PREMIER PEDIATRICS, LLC
Practice address
150 SE 17TH St
Suite 604
Ocala, FL 34471-5178
Phone
(352) 671-6741
Fax
(352) 671-6742
NPI assigned
Sep 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Authorized official

Name
Shahab Eunus
Title
President
Phone
(352) 671-6741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME96086 FL Primary

Addresses

Primary practice location

150 SE 17TH St
Suite 604
Ocala, FL 34471-5178

Mailing address

7960 SW 60TH Ave
Ocala, FL 34476-6457
Phone (352) 671-6741

Other identifiers 1

IdentifierTypeStateIssuer
003198502MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Premier Pediatrics LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

150 SE 17th St
Ste 604
Ocala, FL 34471
Phone (352) 671-6741

NPI Registry JSON

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1831525930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7960 SW 60TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344766457",
            "telephone_number": "352-671-6741",
            "fax_number": "352-671-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SE 17TH ST",
            "address_2": "SUITE 604",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344715178",
            "telephone_number": "352-671-6741",
            "fax_number": "352-671-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "EUNUS",
        "authorized_official_first_name": "SHAHAB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-671-6741"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME96086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003198502",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.