Premier Adult and Childrens Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PREMIER ADULT AND CHILDRENS SURGERY CENTER LLC

Practice address

5238 Mason Corbin CT Ste 101
Fort Myers, FL 33907-7738

Phone

(239) 936-9700

Fax

(239) 936-9707

NPI assigned

Jun 20, 2019

Last updated

Jun 20, 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

Jenetha D Moran

Title

Officer/Authorized Official

Phone

(972) 763-3893

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1861052896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5238 MASON CORBIN CT STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077738",
            "telephone_number": "239-936-9700",
            "fax_number": "239-936-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5238 MASON CORBIN CT STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077738",
            "telephone_number": "239-936-9700",
            "fax_number": "239-936-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ADULT AND CHILDRENS SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "JENETHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "972-763-3893"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Premier Mobile Health Services Corporation
• Premier Mobile Medical Clinic PLLC
• Premier Rna LLC
• Premiere Care LLC

• Ambulatory Surgical Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

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