Provider Demographics
NPI:1487211769
Name:PREMIER HEALTHCARE SOLUTIONS LLC
Entity type:Organization
Organization Name:PREMIER HEALTHCARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-516-3972
Mailing Address - Street 1:8958 CONROY WINDERMERE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3128
Mailing Address - Country:US
Mailing Address - Phone:352-516-3972
Mailing Address - Fax:
Practice Address - Street 1:8958 CONROY WINDERMERE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3128
Practice Address - Country:US
Practice Address - Phone:352-516-3972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMEDICAREOtherMEDICARE