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PREMIUM PRIMARY CARE & WALK-IN CLINIC INC
NPI 1700654167
Family Medicine in Port St Lucie, FL

Active since December 15, 2023CLIA 10D2298447 · Waiver
1801 SE HILLMOOR DR UNIT A-107P, PORT ST LUCIE, FL 34952(772) 446-0950(772) 446-0956 Get Directions Write a Review

NPPES record last updated: December 15, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Premium Primary Care & Walk-in Clinic Inc NPPES

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

PREMIUM PRIMARY CARE & WALK-IN CLINIC INC (NPI 1700654167) is a healthcare organization registered as a family medicine in Port St Lucie, Florida and active in the NPI registry since December 2023. The organization holds a CLIA Waiver certificate valid through February 1, 2028 and lists Patrick A Vergel De Dios, Aprn, as its authorized official.

NPPES Registry Identity

NPI1700654167
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePREMIUM PRIMARY CARE & WALK-IN CLINIC INC
Location Address1801 SE HILLMOOR DR UNIT A-107PPort St Lucie, FL 34952-7553
Mailing Address1801 Se Hillmoor Dr Unit A-107pPort St Lucie, FL 34952-7553 · (772) 446-0950 · Fax (772) 446-0956
Phone(772) 446-0950
Fax(772) 446-0956
Organization SubpartNo
Authorized OfficialPatrick A Vergel De DiosAprn · (772) 446-0950
Enumeration DateDecember 15, 2023
NPPES CertifiedDecember 15, 2023
✔ NPI 1700654167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1801 SE HILLMOOR DR UNIT A-107P, Port St Lucie, FL 34952
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2298447

Premium Primary Care & Walk In Clinic, Inc · Port Saint Lucie, FL
Active · expires Feb 1, 2028
CLIA Number10D2298447
Laboratory TypePractitioner Other
Certificate Effective DateFebruary 2, 2026
Certificate Expiration DateFebruary 1, 2028
Laboratory DirectorPatrick A. Vergel De Dios
Laboratory Phone(772) 446-0950
Laboratory LocationPremium Primary Care & Walk In Clinic, Inc1801 SE Hillmoor Dr Ste A 107, Port Saint Lucie, FL 34952
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Primary Care & Walk-In Clinic Inc's NPI number?

The NPI number for Premium Primary Care & Walk-In Clinic Inc is 1700654167. It was assigned to this organization in the NPPES registry on December 15, 2023.

Where is Premium Primary Care & Walk-In Clinic Inc located?

Premium Primary Care & Walk-In Clinic Inc is located at 1801 SE Hillmoor Dr Unit A-107p, Port St Lucie, FL 34952. The listed phone number is (772) 446-0950.

What is Premium Primary Care & Walk-In Clinic Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Premium Primary Care & Walk-In Clinic Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2298447) is associated with this NPI, valid through February 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premium Primary Care & Walk-In Clinic Inc was last updated on December 15, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.