Premier Health & Wellness Center of Central Florida LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PREMIER HEALTH & WELLNESS CENTER OF CENTRAL FLORIDA LLC

Practice address

415 E Main St Ste 212
Bartow, FL 33830-4703

Phone

(321) 297-2737

Fax

(877) 797-7978

NPI assigned

Jul 25, 2021

Organization subpart

No

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

Authorized official

Name

Netrena WilsonNPI 1184014052

Title

Owner

Phone

(321) 297-2737

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Netrena Wilson

  • Home Health Aide
  • Bartow, FL
  • NPI 1184014052
  NPD Authorized official

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

{
    "created_epoch": "1627171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627171200000",
    "number": "1861165003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 705",
            "city": "CLARCONA",
            "state": "FL",
            "postal_code": "327100705",
            "telephone_number": "321-297-2737",
            "fax_number": "877-797-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E MAIN ST STE 212",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338304703",
            "telephone_number": "321-297-2737",
            "fax_number": "877-797-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEALTH & WELLNESS CENTER OF CENTRAL FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-25",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-25",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "NETRENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-297-2737"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polk Pediatrics
• Kion Pope
• Alice Porterfield, LMHC
• Jean Powell, ARNP
• Kandyce Powell
• Premier Women'S Care OB/GYN PLLC
• Phimagham Sriramulu Premkanth, M.D.
• Prendiville DDS PLLC
• Mary Teresa Gunning Prendiville, D.D.S.
• Chad Price

• Clinical Medical Laboratory in Bartow, FL
• Providers in Bartow, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2021; 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.