PREMIUM MEDICAL CENTER CORP
NPI 1053971937
Clinic/Center in Virginia Gardens, FL

Q: What is Premium Medical Center Corp's NPI number?

The NPI number for Premium Medical Center Corp is 1053971937. It was assigned to this organization in the NPPES registry on June 13, 2019.

Q: What is Premium Medical Center Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since June 13, 2019

6405 NW 36TH ST STE 111, VIRGINIA GARDENS, FL 33166(786) 334-5047(786) 334-5048 Get Directions Write a Review

NPPES record last updated: January 14, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 22, 2020, Jun 13, 2019 (2 updates tracked since 2019).

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About Premium Medical Center Corp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIUM MEDICAL CENTER CORP (NPI 1053971937) is a healthcare organization registered as a clinic/center in Virginia Gardens, Florida and active in the NPI registry since June 2019. The organization lists Deivys Gonzalez Oliva, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1053971937

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NamePREMIUM MEDICAL CENTER CORP

Location Address6405 NW 36TH ST STE 111Virginia Gardens, FL 33166-6977

Mailing Address6405 Nw 36th St Ste 111Virginia Gardens, FL 33166-6977 · (786) 334-5047 · Fax (786) 334-5048

Phone(786) 334-5047

Fax(786) 334-5048

Organization SubpartNo

Authorized OfficialDeivys Gonzalez OlivaAuthorized Official · (786) 334-5047

Enumeration DateJune 13, 2019

Last NPPES UpdateJanuary 14, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 14, 2025

✔ NPI 1053971937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

6405 NW 36TH ST STE 111, Virginia Gardens, FL 33166

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premium Medical Center Corp's NPI number?

The NPI number for Premium Medical Center Corp is 1053971937. It was assigned to this organization in the NPPES registry on June 13, 2019.

Where is Premium Medical Center Corp located?

Premium Medical Center Corp is located at 6405 NW 36th St Ste 111, Virginia Gardens, FL 33166. The listed phone number is (786) 334-5047.

What is Premium Medical Center Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Premium Medical Center Corp was last updated on January 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.